General information
Russian Public Health Society.

A Vision of Health for Children, Adolescents and Youth in Russia

A Vision of Health for Children, Adolescents and Youth in Russia


RUSSIAN PUBLIC HEALTH ASSOCIATION
_______________________________________________________

 

All-Russia Public Health Policy Forum
Health Education/Promotion among Adolescents in Russia

October 1, 1997 - March 30, 1998

 

A Project sponsored by USAID

 

 

A Vision of Health
for Children, Adolescents and Youth in Russia

 

 

 

Dr. Andrei K. Demine, M.D., Ph.D., M.P.H.

Dr. Irina A. Demina, M.D.

 

_________________________________________________________________________________________________________
RUSSIAN PUBLIC HEALTH ASSOCIATION
_______________________________________________________

All-Russia Public Health Policy Forum
Health Education/Promotion among Adolescents in Russia

October 1, 1997 - March 30, 1998

 

A Project sponsored by USAID

Canadian Feed the Children provided funding for social marketing study

in Ekaterinburg within a CFTC-RPHA project

I. Project Information
II. Basic Positions and Policy Recommendations in the Area of Public Health, Oriented towards the Preservation and Promotion of Health and Welfare of Children, Adolescents and Youth
in Russia A Vision of Health for Children, Adolescents and Youth in Russia, suggested by the Forum participants, and
III. Information about the Future Project Work.

 

Written by:

Dr. Andrey K. Demin, M.D., Ph.D., M.P.H.,
project author and leader, President of Russian Public Health Association, and
Dr. Irina A. Demina, M.D., Vice - President of Russian Public Health Association.

 

Moscow 1998

 


I.

Sound health of children, adolescents and youth is of vital importance for the future of the nation and the world. It is determined to a considerable extent by the social and economic climate in the country, as well as by factors of upbringing, education, family background, quality of environment, availability and quality of medical and social care, relevant attitudes and activities of each citizen, family, society and state. Attaining health and well-being of each citizen, and first of all of children, adolescents and youth should be considered as a major challenge for the government.
The threat to physical health of the nation is alarming. Sources of this threat are found in practically all spheres of life and activities of the state and manifest themselves most vividly in critical condition of systems of health services and social protection of the population, fast increase of consumption of alcohol and illegal drugs. Among the consequences of this deep systemic crisis are the sharp decline of birth rate and average life expectancy, deterioration of population health, deformation of the demographic and social structure of society, undermining of workforce resources being the basis of economic development, decline of the family being the backbone of society. Such development of demographic processes results in decline of spiritual, moral and creative potential of society. (From the Chapter Threats to National Security of the Russian Federation of the Concept of National Security of the Russian Federation, approved by the Decree of the President of the Russian Federation on December 17, 1997 1300). Provision of National Security of the Russian Federation includes also protection of cultural, spiritual and moral heritage, historical traditions and standards of social life. It is necessary for Russia to safeguard its great cultural property, in particular museum and archive collections, main library collections, historical and cultural sites. Special attention should be paid to dissemination of experience of activities of creative - pedagogical schools, cultural and national centers, communities, unions and other institutions, e.g. intended for children, adolescents, youth and students, using mass media, as well as support of national cultures of the peoples of Russia, spiritual and moral, historical traditions and standards of social activities. The major role in preservation of traditional spiritual values belongs to the activity of the Russian Orthodox Church and churches of other confessions. At the same time it is necessary to point to the destructive role of various religious sects; these sects pose a serious threat to spiritual life of the Russian society and represent a direct threat to life and health of the citizens of Russia, and are frequently used for concealing illegal activities. The spiritual revival of society is impossible without rising role of the Russian language. Its adoption as the state language and the language of interstate dialogue of the peoples of Russia and states - participants of Commonwealth of Independent States is the major factor of unify of the people of the multinational Russia. In order to preserve and develop our cultural and spiritual heritage it is necessary to provide optimum economic conditions for implementation of major kinds of creative activities. Provision of National Security of the Russian Federation in the area of health protection and promotion requires increased attention of society, legislative and executive authorities of the Russian Federation to the development of state (Federal and municipal) insurance and private medical services, state protectionism towards domestic medical and pharmaceutical industry, priority funding of health care services and Federal programs in area of public health and epidemiology, protection of health of the children, emergency medical care, medicine of catastrophes. (From the Chapter Provision of National Security of the Russian Federation of the aforementioned Concept).
Unfortunately, youth and health are not always indivisible notions. The Joint Meeting of the Interdepartmental Commissions of the National Security Council of the Russian Federation on Protection of Health of the Population and Research Council of the NSC of the Russian Federation on December 8, 1995 had discussed the issue Health of the Children and Adolescents as the Factor of National Security and concluded that: The current situation should be considered as the factor threatening the national security of Russia and requires emergency measures for its radical improvement... In Russia on a background of demographic crisis, including decline of birth rate, deterioration of the health of the children and adolescents continues. Of special concern are continuously high rates of infant and child mortality, raising morbidity among children starting from postnatal period in practically all groups of diseases, deterioration of health of girls and young men that has a negative impact on the genetic fund of Russia and poses a serious threat to national security. The situation related to reproduction of the population and health status of new generation is aggravated by social economic and political instability in the country. Declining quality of mother and child care is attributed to drop of standard of living of the overwhelming majority of families with children under 18 years of age, and destruction of system of preschool education and health promotion facilities for children, disorganization of nutrition of schoolchildren and declining attention to development of large scale activities in the sphere of physical culture. In large cities pay pediatric and health promotion services are being extended illegally. Despite approval of the Federal program Vakcinoprofilaktika for 1993 1997, increase of infectious diseases among children is registered, that is attributed to poor organization of immunological prevention, underfinancing of the program and deterioration of the sanitary standards at facilities for children. Health of the children is compromised in regions of ecological distress and iodine deficiency. Combination of these factors results in progressing impairment of the mental and physical development of children and adolescents. An important social problem - prevention of disability - is addressed inadequately, and the number of disabled children in Russia, according to forecasts, will increase. Counteraction of such negative social phenomena as alcohol abuse, prostitution, illegal drug abuse, homelessness among children and adolescents is inadequate, as well as medical and social protection of children - orphans and children without parental support, suffering from emergencies.
Addressing the Parliamentary Hearings Health of the Population as the Factor of National Security in Russia held at the State Duma of the Federal Assembly of the Russian Federation on May 13, 1997, Chairman of Committee of the State Duma of the Federal Assembly on Health Protection, Corresponding Member of the Russian Academy of Medical Sciences, Professor Nikolai Gerasimenko declared that the situation is catastrophic: If there will be no change for the better, only 54% of boys, currently 16 year old, will celebrate their 60th anniversary. Every third boy of conscript age is not fit for the army service because of poor health (in 1985 - every 20th). Prevalence of body mass deficit among conscripts is 15%, prevalence of alcohol abusers doubled, up to 12%; 8% are illegal drugs users. Approximately 40% of boys are considered relatively fit for the army service with limitations (in 1985 - less than 4%). 60 years is the retirement age for men in Russia. According to international comparisons, Russia rank in terms of average life expectancy 135th among men, and 130th among women. This is considered the main indicator of quality of life and prosperity of the country. The situation among men deteriorated in recent 100 years.
So far, state, society, and population failed to control impairment of health of children, adolescents and youth. Current state policies, aimed at protection of health of the children, adolescents and youth, and ensuring their survival are not effective. Some social and economic reforms are not adequate to the legislation and some decisions are mere declarations.
It is necessary to break the vicious circle of social inequity, inequality, poverty and disease that is developing fast in Russia. According to research evidence, in particular from Canada, health problems associated with poverty include a greater likelihood of low birth weight, undernutrition, higher levels of infant and childhood death, a higher incidence of long-term disability and injuries, and twice the likelihood of psychiatric disorders and poor school performance.
Among the leading controllable factors of adolescents health decline, especially in relation to incidence of cardiovascular and other non-communicable / communicable diseases as well as the incidence of STDs/HIV/AIDS, is the unacceptably high and rising prevalence of self - destructive behaviors, such as smoking, alcohol use, and high risk sexual practices. In Moscow, 35% of 9-th grade boys and about 14% of girls smoke. Among school graduates 53% of boys and 28% of girls smoke. According to the Ministry of Health of the Russian Federation in 1995 there were 1,627 cases of alcoholism per 100,000 people. This is a 45% increase since 1992. Incidence of alcoholism is also rising. In 1995, children and adolescents made up to 50% of the patients who were treated for the first time in connection with drug and toxic substance abuse. Drug abuse in Russia poses a threat to health of the population, national economy, law and order as well as national security. Number of illegal drug users exceeded 2 million. During recent 10 years the number of deaths attributed to drugs use has increased by 12 times, and among children - by 42 times. The number of new cases of drug addiction among adolescents has increased from 580 in 1988 up to 4,500 in 1997, that is by 7.7 times, and increase that started in 1993, still continues. The number of drug addicts among adolescents had increased by 10 times. It is estimated that the ratio between numbers of registered and unrecorded drug addiction cases is 1: 9-10. The forecast, based on increase of number of adolescents seeking medical care for the first time in connection with use of psychoactive substances, predicts increase of prevalence of drug addiction by 20% by 2005, and by 43% by 2010, compared to 1996. According to expert estimates each drug addict involves into illegal drug use 6 - 10 new users. In 1997 bodies of the Ministry of Interior of the Russian Federation registered approximately 185 thousand crimes, related to illegal drug use (a 91% increase compared to 1996). Recent years have also seen an increase in the incidence of sexually transmitted diseases (STDs) and sera-positive testing for HIV. Currently reported number of cases of syphilis put it at epidemic proportions and the number of HIV infections have increased in some areas by 100%. HIV epidemics is about to hit the general population. There is a close link between increase of drug use in Russia and increase of new cases of AIDS, viral hepatitis and other serious diseases. For example, over 91% of new cases of HIV-infection in 1997 were registered among intravenous drug users.
Functional decline of the human body and onset of many diseases originate in the childhood, and are attributed to a considerable extent to unhealthy lifestyles and behaviors.
In order to stay healthy through ones life span, one has to adopt healthy lifestyles. Healthy lifestyle" in Russian medicine is defined as hygienically grounded forms of daily living that promote health, add life to years and years to life. Healthy lifestyle implies protection of the environment, health promoting leisure time activities, healthy workplaces, adequate rest and nutrition, physical activity, and personal and public hygiene, avoiding unhealthy behaviors. Lack of any of these components may exert a negative impact on human health, especially among children, adolescents and youth.
A young persons growth and development encompass a number of stages prenatal, postnatal, infancy, childhood and adolescence. Youth is searching for identity, and is prone to making mistakes. Among the most typical and especially dangerous risk factors prevalent in this age group is the use of tobacco, alcohol, drugs and toxic substances. Children, adolescents and youth experiment with psychoactive substances, and often underestimate the related risk despite cautions voiced by adults. For example, many smokers believe that they will be able to give up smoking if they wish. Experimenting with psychoactive substances and their consumption usually begins with tobacco and alcohol, followed by hashish and marijuana, and such medicines as barbiturates, stimulators, sedatives, etc. In the end of this tragic marathon the use of opiates and cocaine is typical.
Psychoactive substance use among children, adolescents and youth is associated with changes of sexual behaviors. Evidence from polls conducted in Russia and abroad suggests that among majority of schoolchildren possessing early sexual experience, sexual activity was promoted by use of alcohol and drugs. Permissiveness typical for psychoactive substance users, decline of moral sexual behavior standards, multiple sexual partners, etc. result in high prevalence of STDs and HIV/AIDS.
Such combination of risk factors is typical for contemporary youth and prevents adoption of health promoting lifestyles and behaviors.
In Russia during recent years free choice of individual behaviors, morals, approaches to and formats of education etc. was granted. Therefore research on these issues and on relevant needs of population is needed. Evidence from social marketing research might be helpful.
Health promotion / education and disease prevention have been neglected areas in the routine practice of the Russian health care and education systems, despite availability of important theoretical and practical achievements in Russia and abroad.
Health is sometimes defined as a normal condition of the human organism, ensuring its optimum self-regulation, concerted interaction of its organs and systems and right balance between its functions and external environment. The World Health Organization defines health as a state of complete physical, mental and social well-being. To move toward this optimal state, an individual or group must be able to identify and realize aspirations, to satisfy needs and to change or cope with the environment (World Health Organization, Ottawa Charter for Health Promotion). This definition describes health as a resource for everyday life and as an essential dimension of the quality of our lives.
Health is a basic and dynamic force for children, adolescents and youth, that is influenced by beliefs, biology, living conditions, culture, lifestyle choices, social, spiritual, economic and physical environments. Therefore, health promotion among young people in Russia, as well as in any country, is not the responsibility of any one social economic sector. All groups of society must play a role in safeguarding growth and development of children, adolescents and youth, as well as families in Russia.
Health promotion is the process of enabling people to increase control over and to improve their health. It involves self-care (the decisions and actions people take to create and improve their own health), mutual aid (actions people take to help each other) and creation of conditions and surroundings conducive to health. Children and youth need to be actively involved in enhancing their own health and in making their environments health - promoting. When children and youth are given the opportunity to learn skills of effective decision - making and collaborative problem solving, they can take a larger measure of control over their own health.
Measures aimed at improvement of health of children, adolescents and youth implemented so far in Russia lack consistency, public health dimension, preventative edge, public support and are not adequate to the scope of the problem. Development of the relevant policy, including legislation, is in the beginning, sector and group interests are not harmonized. There is a perceived need in continued independent comprehensive analysis of the current health education/promotion practices in Russia and its administrative territories that could serve as a basis for the relevant measures. There is a critical need for coalition building, including governmental and non-governmental organizations. Effectiveness of relevant medical and social services should be improved. Policies, laws and regulations aimed at prevention and reduction of health risks among children, adolescents and youth should be drafted. Increased, better-informed citizens participation in political and economic decision-making and more effective NGO advocacy of children, adolescents and youth health needs might be of key importance.
There are some important positive developments in the area of health education / promotion among children, adolescents and youth in Russia. Among these are development of health legislation, approval of health care strategy by the Federal Government (August 1997), preparation of the first two health policy documents Towards a Healthy Russia (in 1993 and 1997), accumulation of experience by practitioners in Moscow, Saint-Petersburg, Novosibirsk, Nizhny Novgorod and other regions of Russia. NGOs expand their activity in this area.
There is a recognized need to promote relevant interdepartmental collaboration, especially between health professionals and teachers, and to develop a strategy to address health promotion among children, adolescents and youth for policy makers.
Health education / promotion services tailored for children, adolescents and youth, population-at-large are needed, as well as relevant health education / promotion approaches and materials.
Modern effective approaches to health education / promotion include marketing of health. Current challenge is to develop marketing of health, really competitive towards marketing of risk factors of disease among children, adolescents and youth in Russia. Marketing approaches proved to be especially effective among these groups. Health education started at an early age, if accompanied by creating of supportive physical and social environments may encourage people to choose healthy lifestyles.
Russian health professionals, researchers, and teachers need further training in social marketing research, qualitative analysis, program design and evaluation, review of experience of practitioners and understanding of how to address the target group.
Alleviation of health profile of children, adolescents and youth in Russia is vital for families, society and state, and NGOs might play an ever increasing, important role in building coalitions aimed at health education / promotion among these groups. RPHA, judging by the experience of its activities, might further serve as a catalyst of the response of the Russian society to these public health threats.

All Forum activities were implemented cooperatively with the participation of the State Duma; Commission on Women, Family and Demography Affairs under the President of the Russian Federation, Ministry of Health Care; Ministry of Education; Ministry of Culture, Ministry of Labor and Social Development; State Committee on Youth Affairs, State Committee on Physical Culture and Tourism; Ministry of Internal Affairs; Ministry of Defense; mass media; religious confessions; research community; NGOs, health promotion / education centers (Federal and Oblast) involved in children, adolescent and youth issues, the Russian Academy of Sciences and Russian Academy of Medical Sciences, chapters of the Russian Public Health Association at the territories of the Russian Federation, and citizens. Support for the Forum activities was provided by Russian and foreign charitable organizations and by United States Agency for International Development.

Project activities were implemented according to the Project Goal and Principles. The Project contributed to safeguarding and improving the health and well-being of children, adolescents and youth in Russia through prevention and reduction of controllable adverse effects on health. That was attained by means of developing strategies / recommendations on adolescent health promotion / education with a focus on prevention of adolescent smoking, drinking and STD infection among these age groups.
This activity is aimed at assisting the Russian governmental and non-governmental representatives to address constraints to improving the health status of the Russian population.
The activity contributed to these results through the following outcomes:

  • Sound, comprehensive, inter- and-intra sectoral study and analysis of issues related to adolescent health promotion/ education with a focus on prevention of adolescent smoking, drinking and STD infection implemented, published and distributed. This was attained using the results of the innovative large-scale social marketing study in 10 cities of Russia directly involving 1,491 schoolchildren, 1,054 their parents and 452 their teachers. The soundness of this outcome is secured by direct involvement of the leading relevant research centers and practitioners of Russia into the project activities, as well as by detailed consideration of relevant practical approaches implemented in Moscow, Saint-Petersburg, Novosibirsk, Nizhny Novgorod and other territories of Russia;
  • Modern strategies to address adolescent health promotion/education problems in Russia, including considerations and recommendations suggested by the Forum participants on a non-competitive, comprehensive, intersectoral, inclusive basis. These recommendations are open for use by all interested parties, as well as for all further additions;
  • Drafting policies aimed at prevention and reduction of adverse effects on health of children, adolescents and youth; at the same time enriching the large scale practical activities planned and implemented in Russia by introduction of modern domestic, WHO and international approaches to health promotion and disease prevention;
  • Enhanced intra-intersectoral collaboration in addressing adolescent health education/promotion issues. This was attained due to a truly intersectoral composition of the Forum participants and collaborative spirit of its activities, acknowledged by participants;
  • increased public awareness and participation that was secured by:
    • Numerous publications in all Russia mass media with the total print exceeding 1 million copies,
    • Public involvement in large-scale social marketing research in 10 cities of Russia,
    • Discussions of the Forum materials, planning and implementing follow-up activities based on the Forum materials at the grass-root level, that is furthered after publication and wide distribution of the Forum materials,
  • Complementing efforts of the Russian governmental and non-governmental sectors to address constraints to improving the health status of Russian children, adolescents and youth. This was attained by means of discussing current approaches and activities and familiarizing with them, as well as by bringing together different points of view of the Forum participants, representing governmental and non-governmental organizations;
  • Attaining increased, better informed citizens participation in political and economic decision making related to health and well being of children, adolescents and youth. This was attained by means of wide distribution of the Forum materials and practical recommendations;
  • Facilitating more effective NGO advocacy of peoples needs by supporting activities of governmental and non-governmental organizations working in the area of children, adolescent and youth health promotion. This was secured by means of developing a coalition Health to Children, Adolescents and Youth in Russia!. This coalition attracts new members, using the Forum materials and recommendations in planning and implementing the relevant activities. The territorial chapters of RPHA, that is serving as an umbrella NGO, take an active part in this process;
  • innovative approaches and tools for adolescent health education/promotion developed and implemented in Russia by the leading research centers and practitioners from Moscow, Saint-Petersburg, Nizhny Novgorod, Novosibirsk were considered by the Forum participants and made available for use by all interested parties;
  • Awareness and participation of organizations at the federal and regional levels increased through dissemination of information generated during the Forum implementation.
  • The project activities contributed to:
  • Enhancing the strengths and involvement of adolescents in creating, maintaining and improving their own health by means of:
    • Their direct involvement in large-scale social marketing study;
    • Availability of the comprehensible Forum materials and recommendations based on recent trustworthy information produced by the leading Russian experts and practitioners from the governmental as well as non-governmental sectors;
    • Follow-up discussions of the Forum materials and social marketing research results at schools, in adolescent and youth audiences at the grass-root level, including sites of research conducted within the Forum agenda;
  • Ensuring that all adolescents in Russia have access to the necessary living conditions required for optimal health and growth by means of addressing the statements on the Rights of the Child, Adolescent and Youth and relevant recommendations, formulated by Forum participants, to the responsible governmental agencies, prompting their immediate action;
  • Promoting healthy behaviors and reducing the incidence of preventable death, disability, injury and illness among adolescents within the process of diffusion of the Forum materials and recommendations into the Russian society, and their practical use by all interested parties and population-at-large, aimed at:
  • - Fostering strong and supportive families, caregivers and communities,
  • - Ensuring a safe, sustainable, high-quality physical environment for adolescents,
  • - Providing a comprehensive, cost-effective network of policies, programs and services for all adolescents, that stress health promotion, prevention, protection and care.
  •  
  • The Forum activities are based on the following principles:
  • The Forum is open to all parties interested in the discussion of its issues.
  • Participation in the Forum activities is voluntary.
  • All participants of the Forum have equal rights.
  • An interdisciplinary public health approach to the analysis of problems and a joint effort by governmental and non-governmental organizations.
  • Professionalism.
  • A practical approach to solving problems.
  • Consideration and use of international experience.

Implementing the Forum activities, RPHA built upon experience of its projects, including Public Health Policy Forum Alcohol and Health, Health Promotion and Disease Prevention Among School Populations, publication of Public Health Policy Reports series Health for all - All for health in Russia on the key topics relevant to the proposed activity. RPHA also used its well-established collaboration with governmental agencies: State Duma, Federal and Territorial governments, Ministries, Presidential Commission on Women, Family and Demography Affairs, etc., non-governmental organizations: International Child and Mother Fund, International Charity and Health Fund, AIDS-Infoshare, Russian Family Planning Association, Association of Physicians of Russia, etc., mass media, research community. Special emphasis was made on participation and activities of RPHA chapters, currently at 45 administrative territories of Russia. The RPHA also brought in its experience of technical and organizational collaboration within World Federation of Public Health Associations, European Public Health Association, International Council on Alcohol and Addictions, as well as with Canadian Public Health Association, Canadian Feed the Children, Central European Center for Health and Environment, and also with WHO.

The Forum activity during October 1, 1997 - March 30, 1998 included:

Establishing a consultative committee to steer the process of strategy development. This committee included representatives of interested sectors: State Duma; Ministry of Health Care; Ministry of Education; Ministry of Culture, Ministry of Labor and Social Development; State Committee on Youth Affairs, State Committee on Physical Culture and Sports; Ministry of Internal Affairs; Ministry of Defense; mass media; religious confessions; research community; NGOs, researchers, health promotion/education centers of federal and Oblast levels involved in adolescent issues.
The consultative committee conducted six meetings:

  • to develop an activity workplan, timeframe, and a marketing plan; to identify and finalize activity of participants and contributors: governmental and NGOs, international donors, etc.;
  • to discuss survey methodology and questionnaires, to study the existing practices and approaches to the issues of adolescent health education/health promotion;
  • to discuss results of the conducted survey;
  • based on the conducted survey, to identify and specify topics for discussions at the policy workshops; to develop agendas of policy workshops and the final conference;
  • to review materials of the policy workshops; to draft and discuss policy recommendations;
  • to specify topics for discussion at the final conference, to approve a list of participants; to develop the agenda of the conference; to issue letters of invitation to participants and observers.

Social marketing research on health education/promotion among children, adolescents and youth. Data on current practices and approaches to health education / promotion among children, adolescents and youth was collected by interviewing three target groups: 1) schoolchildren of 5 - 8 grades and schoolchildren of 9 - 11 grades; 2) their teachers at school; 3) their parents. Survey methodology and questionnaires were designed by the leading Russian experts with due consideration of relevant Russian and international experience and discussed at the project consultative committee meeting. Sample survey was conducted in October November 1997 in 10 cities of Russia: Ekaterinburg (with support by funding from Canadian Feed the Children), Kaliningrad, Kemerovo, Krasnodar, Moscow, Novosibirsk, Orenburg, Perm, Saint-Petersburg, Yaroslavl. The sample survey provided information on current activities and expectations of the target groups. Survey results are presented in the Survey Report (in Russian) and Summary (in Russian and in English) with tables and figures. These documents are available at the RPHA office in Moscow. Excerpts form the English Summary are included into this publication.

The meetings of the health policy experts aimed at development of strategy / recommendations, first of all on involvement of children, adolescents and youth in improvement of their own health were conducted in December 1997 - February 1998 in order to discuss the topics specified after the survey. The following issues were discussed:

  • challenges to health education/promotion among children, adolescents and youth in Russia;
  • health education/ promotion practices in Russia (results of the survey in 10 cities of Russia);
  • assessment of the schoolchildren / teachers / parents needs and their correlation to existing practice;
  • evaluation of the current practices and search for innovative approaches;
  • roles of health care and educational systems in promoting children, adolescent and youth health;
  • the role of mass media and advertising firms, producing materials targeted at the children, adolescents and youth and influencing their lifestyles;
  • legislative aspects, Federal/regional programs to support health education among children, adolescents and youth;
  • the involvement of the health promotion research institutes and centers for medical prevention. Community involvement in creating a healthy environment;
  • collaboration of the governmental and non-governmental organizations, including children, adolescent and youth centers. Application and adaptation of international experience;
  • the role of the Russian Orthodox Church in health education / promotion among the children, adolescents and youth in Russia;
  • family planning education;
  • coordination of interests of separate sectors and groups;
  • enhanced intersectoral collaboration for the benefit of health of children, adolescents and youth. Development of health education / promotion among children, adolescents and youth on the basis of collaboration between health professionals and teachers. Communicating information on relevant approaches to policy makers;
  • development and use of social marketing of health, really competitive towards marketing of risk factors of disease among children, adolescents and youth;
  • ensuring supportive natural and social environments, facilitating health promotion among children, adolescents and youth;
  • development of recommendations aimed at prevention and alleviation of the unfavorable impacts on health of children, adolescents and youth. Expanding involvement of children, adolescents and youth in creation, preservation and improvement of their own health. Ensuring access of all children, adolescents and youth in Russia to living conditions, necessary for optimum health and development. Encouragement of health promoting behaviors. Reduction of avoidable death, disability, injuries and diseases among children, adolescents and youth. Support of healthy and caring family. Ensuring safe, sustainable, high-quality physical environments for children, adolescents and youth. Ensuring comprehensive cost effective set of policies, programs and services for children, adolescents and youth with an emphasis on health promotion, risk prevention, protection and provision of care;
  • increased awareness and participation of children, adolescents and youth, public-at-large in health education / promotion among children, adolescents and youth in Russia;
  • innovative approaches to health education / promotion among children, adolescents and youth in Russia;
  • increased awareness and participation of organizations at the Federal and regional levels by means of dissemination of information on health education / promotion among children, adolescents and youth in Russia, etc.
  •  
  • Relevant background policy papers and proposals on children, adolescent and youth health education / promotion, related to current and future challenges were commissioned by RPHA, prepared, and delivered at the meetings by representatives of and leading experts from the interested sectors: State Duma; Ministry of Health Care; Ministry of Education; Ministry of Culture, Ministry of Labor and Social Development; State Committee on Youth Affairs, State Committee on Physical Culture and Tourism; Ministry of Internal Affairs; Ministry of Defense; mass media; religious confessions; research community; NGOs in order to facilitate a broad-based discussion. Each workshop considered recommendation/s that were presented and discussed at the All - Russia conference.
  •  
  • Members of the Consultative Committee of the Project:
  • Dr. Demine .. - RPHA President, MD, Ph.D., MPH, Specialist in Social Medicine (Chairman),
  • Professor Glazunov I.S. State Research Center of Preventive Medicine under Ministry of Health of Russia, Head of Department of Development of Policy and Strategy on Non-communicable Diseases Prevention, MD, D.Sc.,
  • Mr. Ilyin A.R. State Statistical Committee of Russia, Head of Department of Statistics of Services, Transport and Communication,
  • Dr. Kakorina E.P. Semashko Research Institute under Academy of Medical Sciences of Russia, Head of Department, MD, Ph.D.,
  • Dr. Koshkina Ye.A.- Research Institute of Narcology under Ministry of Health of Russia, Chief of Department of Epidemiology, MD, D.Sc.,
  • Mr. Kuznetsov V.N. Ministry of Secondary and Vocational Education of Russia, Leading Specialist, Department of Secondary School Education,
  • Dr. Miroshnichenko O.I. Russian Family Planning Association, Head of Projects, MD,
  • Dr. Paronyan I.D. Research Institute of Narcology under Ministry of Health of Russia, Leading Researcher, MD, Ph.D.,
  • Dr. Schepliagina L.A. Research Center on Protection of Health of Children and Adolescents under Academy of Medical Sciences of Russia, Deputy Director on Research, Director of Environmental Programs of International Fund for Protection of Mother and Child Health, Director of Center of Information and Education of the Fund, MD, D.Sc.,
  • Dr. Skvortsova E.S. Head of the Center of Monitoring of Unhealthy Behaviors Among Children and Adolescents of Russia based at Research Production Amalgamation MedSocEconomInform under Ministry of Health of Russia, MD, D.Sc.,
  • Dr. Tkachenko G.B. Chief Specialist, Ministry of Health of Russian Federation, Ph.D., Associate Professor,
  • Dr. Vartapetova N.V. State Research Center of Preventive Medicine under Ministry of Health of Russia, Leading Researcher at Department of Development of Policy and Strategy of Non-communicable Diseases Prevention, MD, Ph.D.,
  • Dr. Vishnevskaya E.L. Federal Research Institute of Medical Problems of Development of Health under Ministry of Health of Russia, Head of Department, MD, Ph.D.,
  •  
  • Besides those listed, the following experts participated in the meetings of the Council:
  • Dr. Aleksandrov A.A. State Research Center of Preventive Medicine under Ministry of Health of Russia, Head of Department, D.Sc., MD,
  • Ms. Barinova M.M. ITAR-TASS Information Agency, Staff Writer,
  • Mr. Belozyorov G.D. NGO Feed the Children, Deputy Director of Office in Moscow, Ph.D.,
  • Ms. Chistova E.A. State Committee of Russian Federation on Youth, Chief Specialist, Department of Social Programs,
  • Professor Chubkova G.P. State Duma of Federal Assembly of Russian Federation (Parliament of Russia), Interparliamentary Group of Russian Federation, D.Sc.,
  • Dr. Demina I.. RPHA, Vice-President, MD, Specialist in Cardiology,
  • Mr. Dobchinov S.V.- Semashko Research Institute under Academy of Medical Sciences of Russia, Researcher,
  • Ms. Fedorovich S.G. Magazine Russia, Staff Writer,
  • Ms. Fokina N.S. Newspaper Trud, Staff Writer,
  • Professor Gromyko Yu.V. Head of Center of Regional Policy of Education under Russian Academy of Education, D.Sc.,
  • Ms. Goodrick L. NGO Feed the Children, Head of Health Programs,
  • Ms. Hizhniakova E.V. Center of Regional Policy of Education under Russian Academy of Education, Senior Researcher, Ph.D.,
  • Dr. Levshin V.F. Oncological Research Center under Russian Academy of Medical Sciences, Head of Department, D.Sc.,
  • Dr. Mirskaya N.B. Federal Research Institute of Medical Problems of Development of Health under Ministry of Health of Russia, MD, Ph.D.,
  • Mr. Mochenov V.P. State Committee of Russia on Physical Culture and Tourism, Deputy Head, Department of Research and Education Institutions,
  • Ms. Papkova T.P. Ministry of Internal Affairs of Russia, Staff Member of Chief Department of Public Order, Department of Prevention,
  • Ms. Shetinina M.V. Newspaper Medicinsky Vestnik, Staff Writer,
  • Dr. Solovyova I.M. - State Research Center of Preventive Medicine under Ministry of Health of Russia, Leading Researcher at Department of Development of Policy and Strategy of Non-communicable Diseases Prevention, MD, Ph.D.,
  • Ms. Tsarkova V.S. State Duma of Federal Assembly of Russian Federation (Parliament of Russia), Committee on Health Protection, Staff Consultant,
  • Dr. Vladimirtsev V.A. Russian Zemstvo Public Movement, Head of Health Programs, Ph.D.,
  • Ms. Voziianova N.V.- USAID Moscow, Specialist,
  • Ms. Umetskaya S.I. State Duma of Federal Assembly of Russian Federation (Parliament of Russia), Committee on Health Protection, Chief of Staff.
  •  
  • Among the authors of public health policy papers of the Project:
  • Dr. Aleksandrov A.A. State Research Center of Preventive Medicine under Ministry of Health of Russia, MD, D.Sc.,
  • Ms. Chistova E.A. State Committee of Russian Federation on Youth, Chief Specialist, Department of Social Programs,
  • Ms. Fokina N.S. Newspaper Trud, Staff Writer,
  • Prof. Gromyko Yu.V. - Center of Regional Policy of Education under Russian Academy of Education, Chief, D.Sc.,
  • Ms. Hizhniakova E.V. Center of Regional Policy of Education under Russian Academy of Education, Senior Researcher, Ph.D.,
  • Rev. Aleksandr Ilyashenko, Priest of the Vysokopetrovsky Church, The Russian Orthodox Church,
  • Mr. Ilyin A.R. State Statistical Committee of Russia, Head of Department of Statistics of Services, Transport and Communication,
  • Mr. Kuznetsov V.N. Ministry of Secondary and Vocational Education of Russia, Leading Specialist, Department of Secondary School Education,
  • Mr. Mochenov V.P. State Committee of Russia on Physical Culture and Tourism, Deputy Head, Department of Research and Education Institutions,
  • Ms. Papkova T.P. Ministry of Internal Affairs of Russia, Staff Member of Chief Department of Public Order, Department of Prevention of Breeches of the Law,
  • Dr. Tkachenko G.B. Chief Specialist, Ministry of Health of Russian Federation, Ph.D., Associate Professor,
  • Ms. Tsarkova V.S. State Duma of Federal Assembly of Russian Federation (Parliament of Russia), Committee on Health Protection, Staff Consultant,
  • Dr. Schepliagina L.A. Research Center on Protection of Health of Children and Adolescents under Academy of Medical Sciences of Russia, Deputy Director on Research, Director of Environmental Programs of International Fund for Protection of Health of Mother and Child, Director of Center of Information and Education of the Fund, MD, D.Sc.,
  • Dr. Vartapetova N.V. State Research Center of Preventive Medicine under Ministry of Health of Russia, Leading Researcher at Department of Development of Policy and Strategy of Non-communicable Diseases Prevention, MD, Ph.D.
  •  
  • An All-Russia Public Health Policy Conference Health Education / Promotion Among Adolescents in Russia: Challenges and Policy Recommendations was convened March 12, 1998 in Moscow, Russia. The Conference was organized by the Russian Public Health Association (RPHA) and the Health and Environment Foundation (Moscow).
  • Participation of the representatives from the territories of Russia as well as international participation was promoted by the RPHA. Reports of the sample survey, and the policy workshops were prepared, published (150 copies) and presented 2 weeks prior to the Conference, and discussed at the Conference. International donor organizations were invited to participate in the conference. Among them: USAID, USAID grantees and contractors, World Bank, UNESCO, UNICEF.
  • The participants of the Conference representing all parties interested in discussion of issues of health of children, adolescents and youth, discussed policy recommendations/strategies and established a Coalition Health for Children, Adolescents and Youth in Russia.
  •  
  • The project activities are based on the national (Russian Federation National Plan of Actions in the Interests of Children, adopted on 14 September 1995, and other) and international (United Nations Convention on the Rights of the Child, adopted in 1989, World Declaration on Securing Survival and Protection of Children, adopted 30 September 1990, World Health Organization Ottawa Charter for Health Promotion, and other) documents, as well as evidence from social marketing research, implemented at the first stage of the Forum.
  • Materials of the Forum were submitted to Russian Parliament - Federal Assembly and State Duma, Federal Government, Ministry of Finance, Ministry of Economics, Ministry of Labor and Social Development, Ministry of Secondary and Vocational Education, Ministry of Health, State Alcohol Inspection, Ministry of Internal Affairs, Court system, Russian Academy of Sciences, Russian Academy of Medical Sciences, Administrations of territories of Russia, NGOs, experts, mass media, public-at-large, all interested parties.
  • This experience is being extended to other administrative territories of Russia, and forms the basis for lasting effective collaboration of RPHA, governmental and non-governmental organizations.
  •  
  • The Parliament of the Russian Federation and the Ministry of Health of the Russian Federation greeted the participants of the Forum.
  •  
  • Representatives of the following bodies participated in the Forum and the Conference: the Russian Parliament - State Duma Committee on Population Health Protection, Ministry of Internal Affairs of Russia, Ministry of Secondary and Vocational Education, Ministry of Defense of the Russian Federation, Ministry of Health of the Russian Federation, State Committee of the Russian Federation on Physical Culture and Tourism, State Committee of the Russian Federation on Youth Affairs, State Committee of the Russian Federation on Statistics, non-governmental organizations and movements: Russian Orthodox Church, the Russian Public Health Association, the Russian Family Planning Association, Russian Charitable Foundation No to Alcoholism and Drug Addiction, International Charity and Health Foundation, International Association for Assistance to Implementation of the United Nations Convention on the Rights of the Child and World Declaration on Securing Survival and Protection of Children Our Future, All-Russia Public Movement Education - Future of Russia, All-Russia Public Movement For the Healthy Russia, International Organization SALUS, Moscow Union of Sahadgy-Yoga, research centers and educational facilities - State Research Center of Preventive Medicine under Ministry of Health of the Russian Federation, Federal Research Institute of Medical Problems of Development of Health under Ministry of Health of Russia, Semashko Research Institute under Academy of Medical Sciences of Russia, Oncological Research Center under Russian Academy of Medical Sciences, Research Institute of Narcology under Ministry of Health of Russia, Center of Monitoring of Unhealthy Behaviors Among Children and Adolescents of Russia based at Research Production Amalgamation MedSocEconomInform under Ministry of Health of Russia, Education - Pedagogical Complex Mitino 18 under North-West Administrative Region of Moscow, Research Center on Protection of Health of Children and Adolescents under Academy of Medical Sciences of Russia, International Fund for Protection of Health of Mother and Child, Center of Regional Policy of Education under Russian Academy of Education, Institute of Sociology under Russian Academy of Sciences, Research Institute of Ministry of Internal Affairs of Russia, mass media - Radiostation MAYAK, RenTV - News, newspaper Trud, newspaper Medicinsky Vestnik, ITAR-TASS, Radio Liberty, Medicinskaya Gazeta, Associated Press, Center for Communication with Media and the Public of the Embassy of USA in Moscow and United States Agency of International Development, foreign and international organizations - United States Agency of International Development (Moscow Office), International Organization Physicians of the World, International Federation of Red Cross (Moscow), UNESCO, International Organization Feed the Children, Soros Foundation, territories of the Russian Federation - Moscow Oblast Narcological Dispensary, Centre on Narcological Problems Revival, secondary school 7, school 1 of Dubna City in Moscow Oblast, Medical psychological Center on Problems of Chemical Dependence, Regional Psychological Medical Pedagogical Service, City Directorate of Education of Dmitrov City in Moscow Oblast, Medical Psychological Center on Alcohol Problems, Youth Centre of Taldom City in Moscow Oblast, Rehabilitation Narcological Center of Zaprudnya City in Moscow Oblast, Narcological Center for Adolescents of Mytishy City in Moscow Oblast, Novosibirsk - NIPKRO, GMCV Magistr, Chief Directorate of Education of the Oblast and the City, St.-Petersburg University of Pedagogical Skill, Research and Consultative Center of Medical and Pedagogical Support of Educational Establishments in Nizhny Novgorod, Care Center Well-being in Mitino Municipality in Moscow, Municipal Medical Psychological Center HOLIS in Ekaterinburg, chapters of Russian Public Health Association in St.-Petersburg, Karelian Republic, Novosibirsk Oblast.
  •  
  • To date, the outcomes of the Forum include:
  • A sound independent analysis of issues related to children, adolescent and youth health education / promotion in Russia, available to all interested parties.
  • Opinions and recommendations on public health policy for the Russian governmental and non-governmental sectors, suggested by the Forum participants and aimed at health protection and promotion, ensuring well - being of children, adolescents and youth, health education / promotion among these population groups in Russia.
  • Heightened awareness of governmental and non-governmental organizations, population - at - large on issues of health education / promotion among children, adolescents and youth in Russia.
  • Publication of materials of the Forum in the Series "Health for All-All for Health in Russia" in Russian and in English, as well as at the RPHA Website <http://www.glasnet.ru/~hefrus>.
  •  
  • The Forum participants developed comprehensive recommendations on health education / promotion among children, adolescents and youth in Russia. The recommendations are based on a balanced independent analysis. This analysis includes opinions of separate sectors and groups. It serves as a unique comprehensive information source for governmental and non-governmental organizations and public-at-large. It presents existing opportunities and threats and promotes building of coalitions at the local level. These coalitions are aimed at raising awareness of governmental and non-governmental organizations and public-at-large on various issues of health of children, adolescents and youth. Russian governmental and non-governmental organizations, experts, and mass media extensively communicate the Forum materials to population and professionals. Materials of the project were presented at the meeting of the NGO Council of the Inter - Parliamentary Group of the Parliament of Russian Federation, at the Meeting of Presidential Commission on Women, Family and Demography Affairs on prevention of illicit drug use, at the Forum of NGOs to Defend Rights, Health and Life of the Child, at the International Seminar of the Pompidou group on illicit drugs, etc. Mass media representatives were briefed on the project before, during and after the Conference. There were numerous publications in mass media on the Forum activities, including ITAR-TASS information agency (on 12 March 1998), newspaper Trud with circulation over 1 million copies (on 11 March 1998), Medicinskiy Vestnik (in March 1998), Medicinskaya Gazeta (in March 1998), Radio stations MAYAK broadcasting to Russia and NIS (on 12 March 1998), Echo Moskvy, Radio Liberty, Associated Press, Press-Center of the US Embassy in Moscow (on 9 March 1998). Further publications are pending.
  • Document on the Forum activities including policy recommendations was printed in 250 copies and widely distributed for comments among the Forum participants, participants of the Forum of Non-governmental organizations to defend rights, health and life of the child (Moscow, 15 May 1998), Conference and Seminars on Prevention of Alcohol Abuse in Lipetsk Oblast (22 23 July 1998), and International Conference Problems of Childhood in Russia: Perspectives of Early Intervention and Early Prevention in Arkhangelsk (29 June 3 July 1998) (enclosed). The Forum document was revised accordingly. The Forum materials are being used at the territories of Russia with support of RPHA chapters, including the Conference and Seminar on Prevention and Control of Psychoactive Substance Use among Children, Adolescents and Youth in Ekaterinburg (24 25 September 1998), Conference and Seminars on Prevention of Alcohol Abuse in Karelian Republic (October 1998), Conference and Seminars on Prevention of Alcohol Abuse in Saint-Petersburg (December 1998), at the Conference National Idea Health of Population (Health, Healthy Lifestyle, Physical Culture and Sport in Oryol on 26-19 November 1998.
  • 2,500 copies of a complete Russian edition on Adolescent Health Education/Promotion in Russia were published, as well as 500 copies of basic results in English and distributed within this project by the Russian Public Health Association as Public Health Policy paper and recommendations Vision of Health Education/Promotion among Children, Adolescents and Youth in Russia, as a basis for development of Child-Youth National Health Goals, and for governmental and non-governmental organizations. This also benefits further development of a Coalition Health for Children, Adolescents and Youth in Russia of the Forum participants developed during the project course, open to all interested parties. The Russian volume includes an introductory article, description of the Project, materials of the Conference: agenda, list of participants, their presentations, materials of the social marketing study in 10 cities of Russia, public health policy papers, final document of the Forum and supplements. The focus of the publication is on the involvement of the adolescents themselves in making and fulfilling the right decisions regarding their health and lifestyle.
  • Activity marketing plan included, among other things, issuance of press release with support of the US Embassy in Moscow, and a press-conference for presentation of the published Forum materials.
  •  
  • The Forum Principle All Participants of the Forum Have Equal Rights implies that this document presents all opinions and recommendations suggested by the Forum participants on an inclusive, non-competitive basis, without approval by the majority of the participants or during preparation of the document. Therefore, this document presents for the first time the current opinions on the issues of health education / promotion aimed at children, adolescents and youth among Russian authorities, researchers, and members of society. These opinions, sometimes differing, can be used as a basis for improving understanding and collaboration among the Forum participants and all interested parties. Discussions of the issues of health education / promotion among children, adolescents and youth by the Forum participants were extensive. Such a Forum takes place in Russia for the first time, therefore all opinions and recommendations, relevant for the Forum topics and suggested by the Forum participants in a wide context are included in the document. The interested parties have an opportunity to choose from this document the most attractive, urgent, acceptable, feasible, etc. recommendations. All interested parties and organizations continue amending this document in collaboration with RPHA.
  •  
  • According to opinions of the Forum participants, the Forum provided for the first time in Russia:
  • - A truly intersectoral discussion of issues of health education / promotion among children, adolescents and youth in a wide context,
  • - A large scale social marketing research of schoolchildren, their parents and teachers in ten large cities of Russia based on a specially developed innovative technique and questionnaire,
  • - A review and publication of extensive information on current situation and practice in the area of health education / promotion in the country, prepared by the experts, representing governmental and non - governmental organizations, all leading scientific and practical centers of Russia,
  • - Collaboration between numerous interested governmental and non-governmental organizations on the basis of the modern concept of health promotion, developed by World Health Organization,
  • - Comprehensive recommendations based of equality of all participants and their opinions, open for further amendments by all interested parties.
  •  
  •  
  • II.
  •  
  • The majority of the Forum participants called for urgent intervention aimed at improvement of health of children, adolescents and youth in Russia, in order to:
  • - alleviate the current catastrophic situation,
  • - ensure survival, protection and development of children, adolescents and youth,
  • - preserve and increase the shrinking population of the Russian Federation,
  • - increase the intellectual, labor and defense potential of the country.
  • For this purpose the Forum supported activities of governmental and non-governmental organizations in the area of health promotion among children, adolescent and youth. A coalition Health to Children, Adolescents and Youth in Russia! was established. This coalition involves new members, using the Forum materials and recommendations for planning and implementing the relevant activities.
  • The Forum participants expressed willingness to use Forum materials in their activities aimed at the benefit of health of children, adolescents and youth.
  • The Forum participants believe that these recommendations will be used for development and implementation of relevant Federal and regional programs and other activities.
  • It is necessary to define terms child - from birth till 12-14-16 years, adolescent - from 12-14-16 till 15-18 years, "youth" - age of transition from an adolescent to adult - from 15-18 up to 21 years. Public health policy recommendations suggested by the Forum participants for safeguarding and improving the health and well-being of children, adolescents and youth in Russia through prevention and reduction of controllable adverse effects on health, by means of developing strategies / recommendations on health promotion / education with a focus on prevention of smoking, drinking and STD infection, are based on these age groups.
  •  
  • The Forum participants believe that all children, adolescents, and youth have fundamental rights and entitlements related to health protection and promotion / health education to the following:
  • - respect as unique individuals and full members of society;
  • - opportunities to create and improve their own health and to contribute to the health and well-being of other individuals, including physical culture and sport activities;
  • - affection, care and support of their immediate social circles; - a healthy environment: physical, social, economic, emotional, cultural and spiritual, that fosters self-expression and self-worth, and enables children, adolescents and youth to reach their full potential;
  • - protection against any compulsion to health destructive behaviors, including encouragement of such behaviors and relevant advertising;- truthful and complete information on issues of health of children, teenagers, youth, existing risks for individual and public health, family, society and state, and possible measures for prevention or counteraction of these risks;
  • - freedom from all forms of discrimination, violence and illegal compulsion on the part of social circles, family, society and state;
  • - access to adequate nutrition, housing and essential social services;
  • - free choice of a full range of existing formal and informal educational challenges and opportunities;
  • - access to appropriate medical and social care and treatment services, support of activities aimed at health protection / promotion;- healthy and safe workplaces;- unconditional compensation of health damage;- privacy, consent and confidentiality;
  • - protection of the above entitlements by their immediate social circles, family, society and state, as an integral part of a right to health protection.
  •  
  • It is expedient to recommend:
  •  
  • That the government organs of all administrative levels and branches of power, local authorities, schools, NGOs, all interested parties, children, adolescents and youth:
  • Ensure moral health of children, adolescents and youth. Ensure that individual behavior is based on healthy moral standards and positive national and family traditions.
  • Support the family. Promote family that is of key importance for the state, because a healthy and caring family preserving healthy moral standards, possessing an adequate level of income is a sound basis for optimal growth and development of children, adolescents and youth, for moral and physical health of family members and sustainability of the nation. Understand that support of the family, including socio-economic assistance when it is needed, is the single most important approach that society can use in order to improve development of children, adolescents and youth, because a healthy two-parent family is the most natural and the cheapest provider of health and well-being of children, adolescents and youth and, therefore of population and the state.
  • Bring together resources and efforts of existing services of state and NGOs on the basis of awareness of the need in health. Declare attainment of well-being of children, adolescents and youth, promotion of their health, reduction of preventable mortality, disability, injuries and diseases as the All Russia National Goals. Ensure that health care is a priority of state, society and family, that all governmental decisions are being made after independent expert evaluation of possible impact on health of children.
  • Children, adolescents and youth must be valued, and must believe themselves to be valued, for their own intrinsic worth, not just as a resource for the future of the family, society and state.
  • Acknowledge that children, adolescents and youth, because of their physical, emotional and intellectual vulnerability, need special protection and care with due consideration of the ethnic and cultural diversity of the population of the Russian Federation.
  • Ensure optimal growth and development of children, adolescents and youth in a nurturing atmosphere of support, happiness, love and understanding.
  • Stop deterioration of the system of education of the Russian Federation. Reorient system of education towards traditional positive moral standards, love and loyalty towards Motherland, its history and culture. Teach children to understand and appreciate beauty of school subjects, literature or folklore, historical or fiction characters, theorems because the beauty of human ideas is granted by the God.
  • Consider upbringing and education in interrelation. Understand that upbringing is a priority direction of activities of Church and family, and education is a priority activity of school. Society should believe that moral and religious education of children is an exclusive right of family. School should not compromise the spirit of the family.
  • Grant to parents and teachers working with children, a freedom of choice of scientifically grounded approaches to health protection and promotion.
  • Preserve the best achievements of the system of health care of the Russian Federation.
  • Raise liability of citizens, family, society and state for health, i.a. by means of legislation development.
  • Reorient state policy towards prevention of disease and antisocial behaviors among children, adolescents and youth. Emphasize use of various techniques aimed at adoption of healthy lifestyles, acquiring knowledge and skills necessary for health protection and promotion, i.a. involvement into regular physical exercise and sports.
  • Involve children, adolescents and youth in development of economic policy at all levels of state and municipal administration. When decisions must be made on behalf of a young, dependent child, he or she must be involved in making them.
  • Prevent and control effectively such negative social phenomena as prostitution, drug addiction, alcohol abuse, homelessness among children, adolescents and youth. Counteract those interested in decay of our children, adolescents and youth.
  • Improve general situation in the Russian Army on the basis of traditional moral standards.
  • Raise the role of parents, teachers and health professionals, children, adolescents and youth, mass media and NGOs in education of children, adolescents and youth on skills necessary for adoption of healthy lifestyles.
  • Address both age and gender differences when formulating specific objectives and operational plans on health education and promotion among children, adolescents and youth, because a young person's growth and development encompass a number of stages (i.e. prenatal, postnatal, infancy, childhood and adolescence).
  • Meet special needs of children, adolescents and youth suffering from poor somatic and mental health.
  •  
  • That the State Duma of the Federal Assembly of the Russian Federation:
  • Consider development and adoption of legislation aimed at health protection and promotion among children, adolescents and youth as a priority.
  • Develop a regulatory base ensuring adequate development of all children, adolescents and youth and an opportunity to satisfy their needs related to spiritual and physical development with due consideration of age. Define terms child - from birth till 12-14-16 years, adolescent - from 12-14-16 till 15-18 years, "youth" - age of transition from an adolescent to adult - from 15-18 up to 21 years.
  • Develop an effective and transparent state policy aimed at health protection and promotion among children, adolescents and youth based on the current concept of health promotion. Adopt a relevant Federal Law.
  • Develop legislation, introducing economic and legal incentives for health awareness and adoption of healthy lifestyles among population, children, adolescents and youth.
  • Envisage legal and administrative liability in case of inappropriate implementation of legislation on health protection among children, adolescents and youth.
  • Ban legally all forms of direct and subliminal advertising of psychoactive substances (alcohol, tobacco, drugs) in the mass media, public places, as well as the encouragement of their consumption.
  • Develop a regulatory base on prevention of illegal drugs and other psychoactive substance use, rehabilitation, registration, treatment and social care on a free-of-charge basis among individuals under 18 years of age. Provide care on anonymous basis.
  • Envisage liability for illegal use of illegal drugs in the criminal legislation, and for use of toxic and other similar substances, as well as for involvement into their consumption in the administrative legislation.
  • Accelerate the passage of Laws On the Bases of the State System on Prevention of Neglect of Individuals Under 18 Years of Age and Offences Committed by These Individuals, On the State Minimal Social Standards, On the Organization of Leisure Time Activities for Children and Families. Amend the Law On Allowances for the Families With Children, increasing the amount of the allowance up to the minimal social standard.
  • Prepare public hearings on social, medical and other aspects of abortions and family planning in the Russian Federation with free participation of all interested parties, including the Russian Orthodox Church.
  • Establish Youth Parliament of Russia (or Youth Ministry of Health), focusing on issues of health protection and promotion.
  • Consider interests of the children, adolescents and youth as a priority in Federal budget. Ensure funding of the Federal programs in the area of health protection and promotion among children, adolescents and youth in the Federal budget.
  • Increase funding of health services up to 7-8 % of GNP. Earmark a specific proportion of funds for health protection and promotion among children, adolescents, youth and women.
  • Earmark funds equal to 1 % of GNP for the development of physical culture and sports, using revenues from lotteries, excises and duties on sale of alcohol and tobacco. Implement similar measures in order to support other types of health promoting activities.
  • Adopt a system of reduced taxation for firms and enterprises, channeling part of their profits for support of sport among children, adolescents and youth. Introduce similar measures in relation to state bodies, public organizations, enterprises working for the benefit of health protection and promotion among children, adolescents and youth, prevention of drug abuse, treatment and rehabilitation of drug addicts.
  • Develop an effective legislative mechanism ensuring liability of mass media in case of publications, harmful for the physical, mental and moral health of children, adolescents and youth.
  •  
  • That the National Security Council of the Russian Federation, the Federal Government:
  • Monitor issues of health of new generations and its promotion.
  • Support programs aimed at health protection and promotion among children, adolescents and youth.
  • Establish an Interdepartmental Commission on Children, Adolescents and Youth Affairs, headed by the Prime Minister in order to facilitate collaboration between interested ministries and departments, public organizations, territories of the Russian Federation.
  •  
  • That the Federal Government of the Russian Federation:
  • Ensure implementation of United Nations Convention on the Rights of the Child, adopted in 1989 and World Declaration on Securing Survival and Protection of Children, adopted 30 September 1990 approved by the Russian Federation and envisaging health protection and promotion activities.
  • Consider health of population as a state property. Ensure that health promotion among children, adolescents and youth is a priority in governmental policy, and relevant funding is provided.
  • Implement social and economic reforms after evaluation of possible impact on health of population, children, adolescents, youth and young families.
  • Ensure implementation of the existing legislation on health protection and promotion among children, adolescents and youth on the basis of the key role of state. Carry out necessary measures to guarantee rights of adolescents to health protection (the Constitution of the Russian Federation, the Bases of the Legislation of the Russian Federation on Protection of Health of Citizens, Bases of the Legislation of the Russian Federation on Physical Culture and Sport, the Law On Education, Family Code of the Russian Federation and other laws) on the basis of liability of state for health protection and promotion among citizens.
  • Develop and implement Federal programs on protection of health, and provide adequate funding in order to ensure the right to a favorable environment, adequate education, information on health and related factors, health education, environmental and sanitary - epidemiological well - being, optimal social and economic development, health services, health protection.
  • Promote natural increase of population of Russia by means of improvement of social and economic living conditions of families with children, i.a.:
  • - increase allowances in case of birth of a child for families with per capita income below minimal social standard up to 25 minimal wages;
  • - increase allowances in case of sick leave for care for the sick child under 3 years of age up to minimal social standard, and allowances for one-parent families with children under 18 years of age up to 3 minimal wages;
  • - reduce payment for stay of children in preschool institutes down to level of minimal wage, with compensation from the local budgets;
  • - grant taxation and other privileges to the manufacturers of food and other goods for children;
  • - ensure credits for housing construction for young families with children.
  • Provide quality food of domestic production for adequate nutrition of children, adolescents and youth.
  • Support organized forms of leisure time activities among children, adolescents and youth.
  • Forbid any pay treatment of children, adolescents and youth in governmental and municipal institutions, maternity clinics as well as privatization of such institutions as an infringement of the Constitution of the Russian Federation.
  • Forbid activities of medical joint-stock companies on the basis of governmental and municipal institutions for children and maternity clinics.
  • Ensure compulsory large - scale prevention of iodine deficiency among population in regions suffering from iodine deficiency in biosphere.
  • Authorize the Ministry of Health of the Russian Federation as the leading organization:
  • - developing governmental policy on health promotion among new generations,
  • - organizing, supervising and coordinating relevant interdepartmental activities,
  • - ensuring priority of health promotion,
  • - ensuring that relevant services are implemented only by approved providers.
  • Expand use of electronic mass media for the benefit of health education / promotion among children, adolescents and youth, including television channel Culture.
  • Establish special radio and television channels for children, adolescents, youth and family.
  • Expand a network of information centers for children, adolescents and youth.
  • Establish a Virtual University of health of children, adolescents and youth.
  • Ensure that all high standard domestic films produced in recent years become a national property. Record these films on videocassettes. Create a network of state shops for dissemination of classic domestic and foreign films at reduced prices.
  • Create an effective system of state bodies and NGOs providing comprehensive social, economic and other activities aimed at health promotion among children, adolescents and youth.
  • Involve NGOs into:
  • - activities on priority issues of health of children, adolescents and youth,
  • - development of state policy in the area of protection of health of new generation,
  • - bringing together their efforts and supporting dissemination of positive experience.
  • Attract attention of society and NGOs to activities aimed at health promotion among new generation.
  • Develop mechanisms of collaboration and coordination of activities of Federal authorities and NGOs, aimed at:
  • - prevention of drug addiction,
  • - detection of children, adolescents and youth, using illicit drugs and other psychoactive substances,
  • - providing necessary care.
  • Create a comprehensive system of prevention of alcoholism and drug addiction as well as narcological care for individuals under 18 years of age using alcohol, and other psychoactive substances. This system should be based on United Nations Convention on the Rights of the Child, UN Recommendations on prevention of criminal offences among individuals under 18 years of age, adopted in 1990 and relevant experience of European countries.
  • Ensure coordination of activities of executive authorities and bodies of local self-management aimed at prevention of alcoholism, drug addiction and toxic substance abuse among individuals under 18 years of age.
  • Ensure funding of activities aimed at protection of health of children and adolescents according to the budget. Avoid inefficient use of resources.
  • Envisage targeted transfers from the Federal budget for protection of health of children, adolescents and youth according to numbers of individuals under 18 years of age adjusted for their age structure.
  • Support proposal of the Ministry of Health of the Russian Federation aimed at allocation of a portion of revenues from excise tax on alcohol and tobacco to funding of activities on health promotion.
  • Ensure additional funding of research into issues of mother and child health in institutes under the Russian Academy of Sciences, the Russian Academy of Medical Sciences, the Ministry of Health of the Russian Federation.
  • Ensure implementation of programs of state guarantees on provision of free medical care and medicines for children, adolescents and youth in state and municipal health services.
  • Approve specific programs of state guarantees related to protection of health of children, adolescents and youth and determine specific proportions of funding from Federal and regional budgets.
  • Develop and approve Federal programs, i.a. Education and Health, Health of Adolescents of Russia, Comprehensive Control of Illicit Drug Use and Their Illegal Turn-over in 1998 2000, Comprehensive program on prevention and control of smoking in the Russian Federation in 1998 2000 and secure relevant funding.
  • Increase liability of civil servants in case of illegal actions or inactivity on issues of health protection and promotion among children, adolescents and youth, including implementation of Federal programs.
  • Speed up preparation of regulatory basis prescribed by the Federal law On Narcotics and Psychotropic Substances.
  • Encourage private capital to invest in area of health protection and promotion of population in emerging market economy.
  •  
  • That the Ministry of Health of the Russian Federation:
  • Consider issues of health promotion among children, adolescents and youth as a priority.
  • Ensure priority development of preventive medical programs aimed at:
  • timely diagnosis of hereditary diseases,
  • reduction of infectious diseases morbidity,
  • prevention of disability among children,
  • prevention of chronic diseases,
  • protection of reproductive health.

Support development of services providing qualified care in the area of health promotion. Prevent use of unapproved methods of treatment on a pay basis.
Create a system of monitoring and forecasting health of children, adolescents and youth, their awareness and behaviors on issues of health protection and promotion, prevention and control of unhealthy behaviors at the Federal and regional levels and ensure functioning of this system.
Create an Internet Website on recent developments in the area of health education / promotion among children, adolescents and youth.
Create an effective system of medical and social rehabilitation of disabled children.
Create a system of health protection and promotion, that meets the needs of children, adolescents, youth and families, and:
- is accessible and provides equitable opportunities;
- responds to individual, children, adolescent, youth, family and community needs in a holistic way;
- enables users to make informed choices and involves them in planning and evaluation of care, provides their continuous education on issues of health protection and promotion;
- provides adequate prevention, protection and treatment services necessary for children, adolescents and youth;
- systematically evaluates treatments and the need for new technologies;
- is cost-effective and has adequate quality assurance mechanisms in place;
- promotes lifelong learning.
Review and approve activities of Valelologic Services.
Support activities aimed at prevention of smoking. Expand activities on prevention of use of alcohol and illicit drugs among children, adolescents and youth.
Develop a Plan of actions on prevention of smoking in the Russian Federation on the basis of Federal and regional programs for years 1998 -2000.
Create a Center of Treatment of Tobacco Addiction under the Ministry of Health of the Russian Federation and an extensive network of preventive and rehabilitation services on smoking prevention and control.
Expand a network of medical and rehabilitation facilities for children, adolescents and youth, needing specialized toxicological care. Expand a network of special narcologic dispensaries for children, narcologic clinics and hospitals, out-patient and in-patient specialized care for adolescents - drug addicts on the basis of reduced payment.
Evaluate efficiency of programs of sexual education at schools jointly with the Ministry of Education of the Russian Federation, interested ministries, departments, NGOs. Review approaches to these activities.

That the Ministry of Secondary and Vocational Education of the Russian Federation jointly with the Academy of Education of Russia and territorial Directorates of Education:
Implement reform of education for the benefit of health promotion among children, adolescents and youth, and review educational programs, school and out- of- school activities.
Ensure that implementation of comprehensive measures aimed at protection of health of children, adolescents and youth in educational institutes is a priority activity of the Ministry according to the Law of the Russian Federation On Education.
Develop strategy of the Ministry of Education on health protection among children, adolescents and youth in educational institutes of the Russian Federation related to implementation of Federal Program Development of Education in Russia.
Ensure transition from uniform education to differentiated education tailored to each child. For that purpose develop and implement at schools a scientifically grounded system of evaluation of individual cognitive, personal and somatic abilities of schoolchildren with consideration of an approved mandatory minimum on each subject. Speed up introduction of state educational standards for adequate workload for schoolchildren. Emphasize issues of health protection and promotion among children, adolescents and youth in educational programs.
Determine somatic and mental price of education programs in.
Improve surveillance of workload of schoolchildren in schools and new non-governmental educational institutes introducing innovative programs of education, health protection and promotion among children, adolescents and youth.
Improve regulatory base on protection of health of children, adolescents and youth in educational institutes. Ensure scientifically grounded techniques of physical exercise for children with compromised health. Ensure effective health promotion and organization of summer vacations.
Expand role of system of education in organizing and bringing together efforts aimed at implementation of concept of health promotion among children, adolescents and youth and collaboration with families. Reorient accordingly school educational program as well as social, ecological, hygienic school environments, all school services, and out-of-school resources towards health promotion among children, adolescents and youth, their comprehensive development and well-being.
Develop and implement educational program within general program of health promotion, including documented, planned and continuos program on education on healthy lifestyles for schoolchildren of all age groups, from kindergartens till 11th grade. Use for this purpose the magazine Basics of Safety of Daily Living. This program should:
- be delivered by specially prepared teachers or as a part of general educational subjects;
- bring together efforts of parents, health professionals and interested representatives of the public;
- include major issues of protection of health and development of specific age group;
- ensure active involvement of higher educational institutes, providing training and postgraduate education, as well as of nation-wide professional associations aimed at improvement of school programs of health promotion.
Develop state program Education and Health envisaging implementation of comprehensive measures aimed at valeological education and other relevant activities.
Expand activities in educational institutes in the sphere of valeology that is a qualitatively new integrative scientific knowledge, based on comprehensive interdisciplinary development and protection of individual health.
Develop regulatory documents at Federal and regional levels on activities of valeological services in system of education envisaging mandatory licensing of valeological centres with participation of Directorates of Education and Health.
Reach consensus on activities of valeological services with the Ministry of Health of the Russian Federation.
Determine contents of valeological education at school bringing together:
- valeological training and education based on school subjects related to natural disciplines,
- subject Basics of Safety of Daily Living,
- various forms of out-of-school activities.
Include subject Valeology into variative part of the basic educational plan as a regional and school component, understanding that its inclusion into federal component of the educational basic plan is currently not possible.
Establish Interdepartmental Coordination Council on Valeological Education under the Ministry of Education of the Russian Federation with participation of the Russian Academy of Education, the Ministry of Health of the Russian Federation, Academy of Medical Sciences of Russia, Committee on Physical Culture and Tourism of the Russian Federation. Expand activities of the Interdepartmental Council under the Academy of Medical Sciences of Russia and the Russian Academy of Education on issues of health and education. Suggest that this Council prepare a joint meeting on Health and Education. Ensure development of educational programs and relevant recommendations on valeology. Implement analysis of health impact of educational programs, recommendations, equipment and health promoting techniques, used in educational institutes. Prepare meetings of relevant academic and research institutes on issues of publication of literature on valeology. Prepare thesaurus on valeology.
Expand preparation and use of educational literature on health protection and promotion among children and adolescents. Evaluation of such materials on valeology should be implemented by the Section on Valeology under the Federal Expert Council under the Ministry of Secondary and Vocational Education of the Russian Federation.
Improve programs of graduate and postgraduate training of teachers on issues of health protection. Ensure that the standard of education for each pedagogical specialty includes modern concept of health promotion among children and adolescents as a mandatory element.
Consider issues of creation of interdepartmental courses / faculties of valeology with participation of health professionals and teachers carried out at several higher education institutes.
Develop a system of professional orientation and selection of teachers of valeology, based on the principle that teacher of health should bring knowledge on health, advocate the concept and use it in his daily life.
Ensure that a course of valeology is mandatory part of training of students of all faculties of high schools in Russia.
Review state educational programs of pedagogical high schools of Russia on valeology in order to expand proportion of fundamental natural sciences (age morphology and physiology, psychophysiology), as well as hygiene of children and adolescents as a necessary prerequisite of high-quality valeological education. Include issues of protection of health in the program of graduate training of all teachers.
Increase number of Chairs of valeology and expand training of teachers on a specialty Pedagogical Valeology.
Develop on a competitive basis a vocational education program and educational literature on teaching valeology in pedagogical high schools of Russia using available experience of 15 high schools of Russia.
Include a special course on valeology into program of advanced training of teachers in all Institutes (Faculties) of advanced training. Provide opportunities for training on valeology as the second higher education at the leading high schools of Russia.
Dedicate more effort to development of centers of valeology under the leading high schools of various regions of Russia.
Prepare an annual School on Physiology of Age and Valeology at the Institute of Physiology of Age under Russian Academy of Education and the leading valeological centers under high schools.
Publish newsletter of Valeological Society of Moscow on results of School on Physiology of Age and Valeology and magazines Valeology, Newsletter of Education, and other periodicals.
Consider as major pilot areas on issues of valeology in education the following territories: Nizhny Novgorod, Saint - Petersburg, Rostov-on-Don, Novosibirsk, Lipetsk. Consider organization of additional federal pilot area in Kemerovo Oblast.
Include specialty Valeology into the current list of specialties for Ph.D. and D.Sc. theses.
Continue development of a network of rehabilitation establishments, special rehabilitation educational institutes for children with impaired development, special rehabilitation classes at secondary schools, classes of compensatory education.
Involve the leading educational institutes of the Russian Federation into development of programs on prevention of drug addiction among children and adolescents. These institutes should also provide training of social teachers for organization of activities aimed at prevention of illicit drugs use among individuals under 18 years of age and youth, and social workers providing care for families with drug addicts or users of illicit drugs.
Prepare a list of products of world culture, first of all films, recommended for children, adolescents and youth, taking into account influence of cinema on spiritual and moral health.
Develop and implement innovative educational projects bringing together public, managers, practitioners, researchers and teachers. Pursue strategic goal of development of technologies of health protection and disease prevention by means of hands-on education and training for improvement of health of children, adolescents and youth.
Develop a comprehensive model of health promotion and adoption of healthy lifestyles among children, adolescents and youth for use by practitioners. For that purpose bring together efforts of various departments, social and public structures and groups. Envisage that in general model of this program involving healthy children into activities aimed at raising their awareness of value of healthy lifestyles, relevant knowledge and skills. Involve also children with compromised health to ensure their social rehabilitation. Ensure that this program provide basis for the system, bringing together issues of health promotion, prevention and care among children with poor health. The program should include development of various modules: nutrition, physical exercise, risk factors, etc. It is necessary to:- develop positive concept of health as a special quality of life, that can be attained only at the basis of values and skills of healthy lifestyles, relevant structuring of living environments and activities. Health is not mere absence of disease;
- design and test technology of development of interdepartmental, intersectoral and multilevel (administrative region, municipality, microregion, local organization, group) coalition;
- review school life to avoid conflict with medical recommendations;
- ensure necessary structural, organizational and environmental changes (new or revised positions, revision of services in educational institutes, etc.);
- develop multilevel training programs for officials responsible for design and implementation of health-related programs;
- develop new pedagogical technologies aimed at understanding the value of health, adoption of healthy behaviors and lifestyles among children, adolescents and youth;
- develop systems of monitoring and evaluation of program, including physiological variables of health, and emphasizing variables describing quality and contents of life;
- ensure involvement of public into relevant activities by means of campaigning in mass media on specific activities implemented at school. Ensure support of parents.
Rely primarily on use of already developed formats of health protection among children and adolescents within system of education:
- developing facilities providing social and rehabilitation space at the local level (i.a. including work with rehabilitation classes, their methodological support, creation of centers of rehabilitation education, rehabilitation educational facilities for disabled children, adolescents and youth, organization of their education at the place of residence, health promotion centers),
- developing a system of social protection for children, adolescents and youth, including telephones of urgent psychological support, etc.,
- developing a system of timely medical and psychological diagnosis of deviations in mental and physical development of children, adolescents and youth,
- developing programs on a special health related subject valeology,
- implementing specific measures, e.g. a campaign for selection of the most healthy school of the year, ensuring participation in children's Olympic movement.

Development of comprehensive model of health promotion and adoption of healthy lifestyles among children, adolescents and youth should take into account, that:
- major results of relevant activities had been achieved mainly in the sphere of early detection of children with deviations from normal development, and their rehabilitation. This direction is of prime importance. However such experience is not appropriate for adoption of knowledge and skills of healthy lifestyles among healthy children,-existing centers of organizational and methodological experience on adoption of healthy lifestyles should be supplemented by a specially organized system of dissemination of positive experience. Therefore experience should be in the format making possible its dissemination. This can be accomplished within special evaluation. Schools serving as pilot areas should be determined for testing of pilot modules on various topics and functions, which then could be disseminated using a network principle,
- current practice in the sphere of health protection and promotion among children and adoption of healthy lifestyles embraces mainly the junior school age. Adolescents are not involved into such activities, in spite of existing methodological and information base. Programs for secondary vocational schools do not exist. At the same time representatives of sphere of education believe that adolescents of junior and average age are the critical age group. Health promoting and educational activities, and methodological recommendations aimed at this group are inadequate.
- further creation of new structures (institutional approach) is not effective in current situation. Until present efforts aimed at development of interdepartmental coalitions resulted in creation of isolated Centers or implementation of local activities (e.g., health checks of specific groups of schoolchildren using resources of health facilities). Efforts should be focused on design and implementation of activities within social infrastructures and environments, based on a network of existing facilities, centers, schools, research centers, departments, regional authorities, bringing together existing activities and tailoring them to new problems.
Consider protection of health of children, adolescents and youth in the context of issues of:
- nutrition,
- physical activity,
- prevention of risk factors (alcohol use, drug addiction, smoking, etc.),
- ensuring safety of daily living (preventing injuries, violence, etc.),
- environmental protection.
It is necessary to ensure friendly and healthy environments for children.
Development of comprehensive model of health promotion and adoption of healthy lifestyles among children, adolescents and youth should envisage attainment of the following goals:
- selecting approaches to ensuring collaboration between spheres of education, health care and environmental protection, related to health of children and environmental health,
- designing local, territorial (municipal) model of interdepartmental collaboration on issues of Healthy Childhood, Adolescence and Youth. Local resources and peculiarities should be accounted for,
-designing a network of pilot areas, formats of accumulation, exchange and dissemination of innovations.
Implement activities on the basis of comprehensive model of health promotion and adoption of healthy lifestyles among children, adolescents and youth on following directions:
- integrated social policy based on education. Collaboration between health professionals, environmentalists, teachers in the sphere of health promotion among children, adolescents and youth. Developing technology of establishing an interdepartmental coalition,
- integrated social and cultural infrastructure of social support of childhood, adolescence and youth,
- designing a network of pilot areas on following directions: healthy and safe space for daily living of children, children's nutrition and physical activity, environmental education, etc.,
-educational - methodological and information support of health,
- planning necessary structural, organizational and environmental changes in educational institutes (introduction or review of positions, changing system of service, etc.),
- selecting directions of programs of training and advanced training for officers, responsible for design and implementation of health oriented programs,
- development of detailed scenario of collaboration with mass media aimed at their active involvement in adoption of healthy lifestyles,
-development of standards of quality of healthy lifestyle for purposes of certification,
-involvement of public, parents, teachers, and other groups.

Implement a number of priority actions, based on comprehensive model of health promotion and adoption of healthy lifestyle among children, adolescents and youth:
- implement as the first stage a social monitoring aimed at understanding needs in health-oriented programs among different groups (schoolchildren of different age, parents, teachers, etc.), analysis of expectations related to format and contents of such programs,
-develop detailed model of interdepartmental collaboration on the issues of healthy childhood down to the level of municipality. This implies review of functions of separate departments, coordination of their activities within the framework of common problems, development of new arrangement of funding. Resulting coalitions will use network of pilot areas based at educational institutes,-create pilot projects (pilot areas) for generating and testing new experience, and a network of pilot areas. Pilot areas should be various in terms of function and topics, depending on interests, opportunities of schools, local ecological and social situation. Such network should ensure exchange of experience, detection of problems related to program implementation, local amendments of contents of the program, mutual-counseling support, involvement of external advisers paid on cooperative basis, etc. The network of pilot areas will provide direct access to authorities of territories. Appeals should be made not only by local school possessing limited opportunities of personal communications, but by the whole area implementing the program,
-develop local and ready - for - use modules, which could be disseminated within the region (on healthy and safe space of daily living of children, children's nutrition and physical activity, environmental education),
-ensure integration of mandatory elements of educational courses around issues of health, embracing all activities of schoolchildren, including extended stay at school, information on vocational training and leisure - time activities,
-organize centers or clubs to promote discussions of issues of health, conditions for development of young person among children, adolescents and youth with participation of experts,
- develop special information and training center for teachers providing advanced training and exchange of experience of practitioners on the following issues:
protection of health within educational activities based on requirements set by the State Sanitary Surveillance service;
rehabilitation activities among children, adolescents and youth with compromised health status,
development of educational programs and versions of educational plans aimed at adoption of healthy lifestyle among schoolchildren,
- provide an infrastructure for pilot testing of research results and recommendations. E.g., create centers of nutrition including a system of correct preparation of food, and elements of training of staff,
- envisage an ecological component in health oriented programs, including:
orientation component (information elements of education at school),
instructive component (standards of healthy lifestyles),
- develop a format of individual Passport of Health for continuous monitoring of health of schoolchildren, supporting rehabilitation activities implemented by teachers within educational process.
Ensure adequate interaction between family, educational institutes and health services aimed at prevention of conflict between correct health knowledge and wrong practical experience of life of family among children, adolescents and youth.

That the Ministry of Internal Affairs of the Russian Federation:
Focus attention on activities aimed at children, adolescents and youth by means of shift of priorities and resources within the Ministry.

That the State Statistical Committee of Russia:
Expand and improve the existing pool of indicators that characterize the health and social protection of children, adolescents and youth nationwide and in the regions. Publish comments on the major developments in mass media.

That the Ministry of Health of the Russian Federation, the Ministry of Education of the Russian Federation, the Ministry of Labor and Social Development of the Russian Federation, the State Committee of the Russian Federation on Physical Culture and Tourism, the Ministry of Interior of the Russian Federation jointly with interested ministries and departments, on the basis of integration of activities:
Create a system of education, based on:
- sound knowledge of development of personality,
- strong motivation, and
- need for protection of personal health and environments.
Submit to the Government of the Russian Federation a draft Ordinance on coordination of relevant activities of bodies of health care, education, social protection, physical culture and sports, etc., directed at improvement of health of children, adolescents and youth.
Develop preventive programs of new generation (so-called behavioral programs) for specific groups of population: children, adolescents, youth and their parents. These programs are based on a comprehensive understanding of the causes of unhealthy behaviors, eliminate contradiction between knowledge and actual behaviors, ensure interactive character of education and training skills of healthy lifestyles in family. Emphasize relevant activities at schools.
Providing research, methodological and other support for demonstration projects on health education / promotion among schoolchildren, staff of educational institutes and members of their families for interested educational institutes at the territories of Russia, including:
- technology of joint activities of teacher, psychologist, physician and other experts,
- support of motivation towards acquiring knowledge and skills of healthy lifestyles among schoolchildren.
Improve lifestyles and behaviors of parents, teachers and physicians, because their lifestyle is a standard for children, adolescents, and youth. Expose unjustified indifferent attitudes of teachers, physicians and parents towards issues of health education / promotion among children, adolescents and youth. Provide parents, teachers and physicians with preventive programs aimed at adoption of healthy lifestyles, i.a. among children, adolescents and youth.
Develop and test new forms of and approaches to health education / promotion activities among children, adolescents and youth based on needs of children, adolescents and youth, within a network of leisure time activities centers, health promoting camps, clubs for children, adolescents and youth.
Continue preparation of joint All-Russia meetings with the chiefs of territorial Directorates of Education and Directorates of Health on:
- improvement of health service, physical education,
- organization of summer rest of children, adolescents and youth,
- health protection and promotion,
- improvement of health services for children, adolescents and youth in educational institutes of Russia,
- conferences of researchers and practitioners and seminars with participation of the leading experts.
Ensure development of service of psychological care, including preventive psychological care, in the country aimed at protection of mental health, timely diagnosis and care for children with poor school performance. These services should be provided by educational institutions, general psychological medical pedagogical consultations, centers of psychological and pedagogical care for children and adolescents.
Increase number of school rehabilitation centers, providing health promotion and treatment for schoolchildren and teachers within educational process.
Increase number of educational institutes of a sanatorium type for treatment of various diseases within the system of education for children who are sick frequently.
Develop a system of measures aimed at protection of health and improvement of medical services for children in educational institutes, providing residence for children.
Develop program Education and Health, as a part of state program Health of Children of Russia, and main directions of activity of ministries and departments within this program for implementation of various activities on health protection among children, adolescents and youth in educational institutes.
Consider possibilities for complementing the current social programs by measures aimed at health education / promotion among children, adolescents and youth.
Expand system of social services for children, adolescents and youth, including organization of:
- activities of centers of social and psychological care for individuals suffering from various forms of chemical dependence,
- narcological services,
- anonymous narcological clinics for children, adolescents and youth and members of their families.Increase activity of existing social and rehabilitation institutes for individuals prone to psychoactive substance use.
Develop drafts of sanitary norms and requirements for educational institutes of sanatorium type for children, adolescents and youth needing long - term treatment.
Monitor observance of requirements SanPiN 2.4.2 - 576-96 (approved by the Decree of State Sanitary Epidemiological Surveillance Committee of the Russian Federation on 31 October 1996, 49), i.a. requirements to conditions of education of schoolchildren in various types of modern secondary educational institutes, requirements to organization of process of education and maximum allowed number of hours per week with consideration of number of week-days.
Develop a comprehensive program on sexual education with participation of parents, health professionals, teachers and psychologists, representatives of arts, confessions, writers, children, adolescents and youth, all interested parties.
Establish centers for mothers under 18 years of age and their children, where they could continue education and raise the children.
Develop a model of youth center of social care in the sphere of family planning and reproductive health, providing counseling services for adolescents, their parents, youth on physiology of sex, ethics and harmony of sexual relations, contraception, prevention of AIDS, alcohol abuse and illicit drugs use.
Speed up development of regulatory base on issues of health promotion. Develop and disseminate recommendations on health promotion among schoolchildren.
Bring together a group of writers, concerned with issues of health of children, adolescents and youth and prepare a relevant conference.
Expand joint activities of experts in the sphere of health promotion among children, adolescents and youth and writers and relevant exchange of information.
Create a data bank for writers on issues of health promotion among children, adolescents and youth.
Continue development of a data base and reference base on campaigning for healthy lifestyles, prevention of smoking, drug addiction and alcoholism, issues of reproductive health, prevention of HIV (on the basis of the Federal Information Center of Youth Social Programs).
Publish and disseminate recommendations, advertisements and leaflets, informing children, adolescents and youth about benefits of healthy lifestyles and helping to avoid exposure to risk factors.
Create an information network for implementation of programs of organization of leisure time activities, health promotion and employment of youth.
Prepare competitions of programs in the sphere of prevention of alcoholism and drug addiction, sexual health, psychology of communication among youth, leisure and health promotion among children, adolescents and youth.
Continue training and advanced training of staff, providing services to the population in the sphere of campaigning for healthy lifestyles, protection of reproductive health and sexual education.
Ensure treatment, social and psychological rehabilitation and prevention of psychoactive substance use along with other state measures, aimed at social protection of children, adolescents and youth, their employment. Ensure concerted activities of customs and policy in control of smuggling and production of illicit drugs.
Ensure expansion of collaboration between bodies on Youth Affairs and youth NGOs aimed at prevention of psychoactive substance use among adolescents and youth.
Prepare materials and recommendations on organization of activities of children's centers aimed at health promotion.
Develop recommendations for leisure time activities of children, adolescents and youth in conditions of social and economic transition in the country in order to prevent psychoactive substance use for improvement of mood.
Prepare an annual All-Russia competition What I Know About Health among schoolchildren, students of vocational schools, colleges and universities, and provide publicity of the competition in mass media.

That all ministries and departments, implementing activities relevant to health of children, adolescents and youth:
Coordinate activities in the sphere of health protection and promotion among children, adolescents and youth with the Federal Ministries of Health and Education.

That Procurator General of the Russian Federation:
Monitor and prevent infringement on the rights of children, adolescents and youth to protection of health, declared in the Constitution of the Russian Federation and Basic Legislation of the Russian Federation on Protection of Health of Citizens.

That Funds of Mandatory Social Insurance:
Consider earmarking portion of funds to pay for the running costs of sports schools, sports clubs, summer camps, clubs, other facilities relevant to health promotion among children, adolescents and youth, especially at the local level.

That the Federal and Territorial Funds of Mandatory Medical Insurance:
Support activities aimed at health promotion among children, adolescents and youth.
Ensure that job descriptions of general practitioners include preventive activities.

That the State Committee on Physical Culture and Tourism:
Develop a system of sports schools as of institutes of complementary education, as well as centers of physical culture and sports at the local level. Ensure support of police, Committees on Youth Affairs and other departments in development of such centers.
Disseminate modern experience of health promoting activities among children, adolescents and youth. Encourage activity of effective volunteer groups in the area of health promotion among children, adolescents and youth.

That the State Committee of the Russian Federation on Publishing, the Federal Service of Russia on Television and Broadcasting, the All-Russia State Television and Broadcasting Company:
Expand campaign on adoption of healthy lifestyles, prevention and control of use of psychoactive substances (illicit drugs, alcohol, tobacco, toxic substance) with emphasis on publications and programs for children, adolescents and youth on a regular basis. Prepare relevant publications and programs jointly with the Ministry of Health of Russia and the Ministry of Education of Russia.
Provide assistance to the Ministry of Health of Russia in preparation of information materials aimed at health protection and promotion among population of Russia on a regular basis.

That legislative authorities at the territories of the Russian Federation:
Implement analysis of the adopted Laws in the sphere of health protection and ensure conformity with the Constitution of the Russian Federation and Federal Laws, e.g. in relation to provision of pay medical services to the population by medical facilities, reduced payments for drugs etc., according to Decree of the Government of the Russian Federation dated 13 January 1996, 27.
Discuss issues of health of children, adolescents and youth in the region, encourage activities of the local authorities, chiefs of education, health care and police institutions aimed at protection of health and health education.

That executive authorities at the territories of the Russian Federation:
Discuss the issues of health education of the population, acquiring information and skills relevant to healthy lifestyles, prevention and control of unhealthy behaviors, e.g. smoking, and develop specific programs of preventive activities of major diseases.
Ensure adequate nutrition and food fortification for all children, adolescents, youth and pregnant women. Restore functioning of the system of hot meals at schools.
Develop an accessible system of stage by stage health promotion and rehabilitation among children, adolescents and youth, especially for needy groups of the population.
Establish treatment and education facilities for rehabilitation of individuals under 18 years of age, using illegal drugs and other psychoactive substances. These facilities should implement preventive activities, provide record - keeping, treatment and social rehabilitation.
Expand network of social rehabilitation centers for individuals under 18 years of age, providing social and medical psychological care and support in case of crises.
Establish a network of regional social rehabilitation services, anonymous counseling facilities based on experience of medical - pedagogical centre Adolescent of the City of Ufa, Youth rehabilitation center of the City of Khabarovsk, City center of adaptation of the City of Novosibirsk providing services for illicit drug abusers after their treatment or for individuals suffering from early stages of drug addiction, toxic substances abuse, alcoholism.
Ensure provision of qualified urgent psychological support over the telephone. Relevant telephone numbers should be available to all interested adolescents.
Develop regional programs on health protection among children, adolescents and youth.
Support development of NGOs of children, adolescents and youth campaigning for adoption of healthy lifestyles, as well as prevention of illicit drugs use. Provide comprehensive support to the existing health-oriented NGOs, monitoring observance of the relevant legislation.
Organize mass media campaigns aimed at prevention and control of illicit drug use.
Approve regional programs on prevention and control of drug use envisaging development of a system of concerted social, medical and other activities.

That Directorates of Education at the territories of the Russian Federation:
Discuss at the relevant meetings the school-based activities aimed at health protection among children, adolescents and youth.
Preserve and develop a network of education establishments of a sanatorium type for the children, needing long term treatment.
Envisage comprehensive activities aimed at health protection and promotion among children, adolescents and youth implemented jointly with Directorates of Health at the local level. Develop programs Health of Schoolchildren. Expand a network of Healthy Schools, providing integrated activities of teachers, health professionals and psychologists on education, health promotion and rehabilitation.

That intergovernmental organizations (WHO, etc.):
Organize conferences, communicate, and disseminate experience and the programs of countries in the sphere of the problem Health Education / Promotion Among Children, Adolescents and Youth.

That schools and other educational institutes, preschool facilities:
Become centers for development of comprehensive system of promotion of health and well-being of the children, adolescents, youth, parents, because health is closely interrelated with school performance.
Bring together, coordinate and direct available local resources for the benefit of promotion of health and well-being at school including health promotion, disease prevention and care for the children with poor health. Review education programs at school, school environments and services promoting health and well-being at school. Involve schoolchildren, teachers and parents in relevant school program.
Pursuing these goals, use strategy based on:
- emphasis on major risk factors and lifestyles that determine health, well-being, abilities to acquire knowledge and skills,
- comprehensive approach bringing together all components of school system, as well as interrelated factors. Involve all interested participants and families. Develop contacts between school and family,
-use of various types of intervention and strategies, developed by experts,
-intersectoral collaboration at all levels,
- active involvement of schoolchildren, i.a. in administration and evaluation of the program, development of services for youth,
- active involvement of teachers. For this purpose develop a program of health promotion at the workplace. Provide training and advanced training on health promotion and healthy lifestyles. Ensure participation of teachers in administration and evaluation of the program,
- active involvement of parents into implementation of activities aimed at health protection and promotion among new generations,
- supporting practice of positive skills, acquired during training,
- promoting changes of social sphere and infrastructures simultaneously with changes of lifestyles,
- use of comprehensive system of planning, monitoring and evaluation of the program and its specific components,
- supporting and developing initiatives of children relevant to health. Establishing Children Health Boards. Providing opportunities for exchange of relevant information and experience between schools.
Introduce lessons of health, valeology including issues of prevention of use of psychoactive substances.
Upgrade programs aimed at health protection and promotion among schoolchildren, staff of schools and other educational institutes and members of their families by means of:
- ensuring and maintaining environments, promoting healthy lifestyles, health protection and promotion among schoolchildren, staff of schools and other educational institutes and members of their families in premises, at playgrounds, through catering services, security services, etc;
- increasing liability of the individual, family, society and state for health;
- encouraging healthy lifestyles. Offering a choice of attractive elements of healthy lifestyles for schoolchildren and staff, members of their families;
- ensuring that the full natural and social potential is reached by schoolchildren and staff, members of their families. Promoting feeling of self-worth among school populations;
- selecting specific issues of health promotion and ensuring security of schoolchildren and staff, members of their families;
- developing communication between schoolchildren and staff, members of their families, school and social infrastructure of the region, including authorities;
- attracting resources available in the region for implementation of activities aimed at health protection and promotion among schoolchildren, staff of school, and members of their families;
- planning of the agreed program of health education using techniques of active involvement of schoolchildren, staff of school, and members of their families into health promoting activities;
- providing knowledge and skills necessary for health protection and promotion, counteracting health risks, maintenance of safe and health promoting health social and physical environments for schoolchildren, staff and members of their families. Improving lifestyles of schoolchildren, staff of school and members of their families aimed at prevention of violence, alcohol use, drug and toxic substance use, smoking, HIV/AIDS. Ensuring adequate nutrition, mental and physical development of schoolchildren, staff of school and members of their families. Providing education on family planning, as well as health education, counseling and specialized care. Providing ecological information according to currently accepted principles of social economic transition to sustainable development;
- involving health care and environmental protection institutes as education resources, supporting activities of schoolchildren, staff of school and members of their families aimed at protecting and promoting health and environmental conservation;
- providing research, methodological and operational support to demonstration projects implemented by the interested educational institutes at the territories of Russia;
- implementing baseline evaluation of health status, lifestyles and environmental issues among schoolchildren, staff of school and members of their families. Evaluation should also include issues of safety of school environments, need in health educational, counseling and specialized care. Documenting this evaluation in the Passport of Health of educational institute, periodically updated with participation of health care and educational institutes;
- involving experts into implementation of activities. Planning and evaluating their input. Preparing publications in mass media on health promoting activities among children, adolescents and youth. Attracting sponsors to funding of activities. Ensuring that activities are supported by authorities. Explaining the aim and contents of activities to schoolchildren, staff of school and members of their families. Developing and evaluating a scientifically grounded program (including evaluation of outcomes and efficiency) with involvement of experts. Preparing and disseminating health education materials;- bringing together a team implementing health promoting activities under direction of the officer. The team should include representatives of schoolchildren, staff of school and parents. Planning and implementation of relevant activities outside school. Providing opportunities for schoolchildren, staff of school and members of their families to participate in implementation of relevant activities. Providing necessary technical support.
Ensure at the phase of planning of activities that teachers are aware of the risk factors that they share with schoolchildren. Teachers and schoolchildren should be interested in health promoting activities at school because they spend a significant part of their lives at school.
Refer to issues of physical, mental and social health during teaching of any subject. Emphasize subjects aimed at health, moral and environmental education.
Ensure development of critical attitude towards unhealthy behaviors among children, starting from early age. This should be supported by activities of teachers at primary school aimed at prevention of smoking, alcohol use etc., and relevant activities of senior schoolchildren that participate in this process in a role of teachers.
Provide environmental education as a part of education on health issues. Ensure active positive attitude of children, adolescents and youth towards nature conservation. Promote specific positive activities.
Support development of various associations of children, adolescents and youth (groups, associations, committees, unions) at schools aimed at health promotion. Support relevant activities of children, adolescents and youth and ensure that they are free to choose formats of positive appropriate activity.
Involve families and parents in various forms of activities aimed at improvement of health of school.
Ensure development and implementation of school programs on health protection among teachers with support of experts.
Support and encourage health-related initiatives of children, adolescents and youth, i.a. clubs, competitions, announcements etc.
Develop a system of advanced training of teachers on health protection and promotion, based on interdisciplinary approach.
Provide information selection, training and employment for teachers of valeology.
Develop a system of training of parents on basics of healthy lifestyles and environmental conservation at schools and preschool facilities with participation of teachers and health professionals, children, adolescents and youth.

That the mass media (press, television, radio):
Consider issues of health of children, adolescents and youth as a priority.
Appeal to the liability and professional standards of writers in order to prevent publications harmful to the health and morals of our children, adolescents and youth.
Play the leading role in developing a need in health promoting behaviors based on positive moral standards, including active lifestyles and physical exercises among population, first of all among children, adolescents and youth. Develop and support a large scale information campaign aimed at adoption of healthy lifestyles. Provide adequate information on prevention and control of smoking, alcohol abuse, obesity, sedentary lifestyles and other risk factors as well as specific recommendations on physical exercises and advertising of sports equipment. Prepare and disseminate videofilms on benefits of active leisure and physical exercises.
Ensure that publications correspond to the general and specific approaches developed by the state for the improvement of health of new generations.
Avoid providing biased information on the Russian Orthodox Church. Ensure that the Russian Orthodox Church, preserving morals and teaching the people, representing the major part of the people, has an adequate access to mass media for information on value of health and positive moral standards.
Publish contact information on accessible emergency medical and social care on a free basis within public service announcements.
Ensure efficiency of publications in terms of adequate response of the government and society.
Provide inexpensive, affordable magazines for children, adolescents and youth, as well as other publications of health - friendly orientation.
Provide regular public service announcements on health of children, adolescents and youth at the state television on a free-of-charge basis.

That international NGOs:
Pass on work experience on health education / promotion among children, adolescents and youth through seminars, conferences, forums, and other means.
That volunteer groups and NGOs active within the sphere of Health Education / Promotion Among Children, Adolescents and Youth:
Create a register and form an association of NGOs active in this area.
Determine key NGOs, based on the focus of their activities, for the coordination of work, the formulation of databases, exchange of information, and promotion of professionalism.
Activate the functions of NGOs in this area.
Present NGOs with recommendations on the principles of the functioning of NGOs in the area of health education, protection and promotion among children, adolescents and youth, their form, methods, and conditions.
Conduct independently and take part in programs and functions for the protection of rights and health of children, adolescents and youth and include the participation of specialists: health professionals, teachers, social workers, and police.
Intensify work with the public on explaining health problems of children, adolescents and youth via the mass media, educational measures, and preventative programs, including those on an individual basis.

That associations of medical workers:
Include into their programs activities, and participate in the carrying out of measures on health education / promotion among children, adolescents and youth.

That the Russian Public Health Association:
Continue social marketing research on healthy lifestyles that collected data by interviewing three target groups: 1) schoolchildren of 5 - 8 grades and schoolchildren of 9 - 11 grades; 2) their teachers at school; 3) their parents. Provide detailed analysis of situation in each of 10 cities of Russia: Ekaterinburg, Kaliningrad, Kemerovo, Krasnodar, Moscow, Novosibirsk, Orenburg, Perm, Saint-Petersburg, Yaroslavl, surveyed in October November 1997.
Work out recommendations for health education / promotion among children, adolescents and youth on various levels of society and submit these recommendations to state authorities at all levels, NGOs, mass media, all interested parties and organizations as the response of the Russian society to declining health of children, adolescents and youth in the country.
Publish and disseminate Forum materials, as well as sanitary - instructional materials for the public.
Prepare regularly conferences on health education / promotion among children, adolescents and youth in order to review innovative experience.
Create as part of the Association a center of practical work with the public on health education / promotion among children, adolescents and youth.
Approach specialists and organizations in Russia and abroad with proposals for collaboration on issues of health education / promotion among children, adolescents and youth.
Implement projects for the development of the Forum's work ensuring support from domestic and foreign foundations.

That parents, teachers and other adults, leaders of public opinion:
Dedicate more active attention, time and effort to children, adolescents and youth. Remember that your lifestyle is a standard, that what you say becomes the truth for children, adolescents, and youth.
Pay attention to development of positive beliefs and attitudes towards health protection and promotion among children, adolescents and youth. Use professional information, developed for children, adolescents and youth.
Ensure that behaviors of children, adolescents and youth are based on ideals of beauty, loyalty, moral obligation, truth, sincere and self-denying love. In that case there is a hope that they will reach adult age healthy and well protected from ill health.
Using professional knowledge and aids prepared by specialists, conduct individual and group preventive activities. Use for this purposes any audience (not only at the workplace) and develop citizen action through the use of reliable data for a convincing argument.
Support willingness of children, adolescents and youth to acquire new health promoting behaviors and skills.
Teach children, adolescents and youth to relieve feelings of tiredness and impact of psychoemotional stresses without use of psychoactive substances.
Participate in activities aimed at development and implementation of the programs on health education / promotion among children, adolescents and youth at all levels.

That children, adolescents and youth:
Be aware of the value of a healthy life and high life expectancy, as well as of current risks for health and life of children, adolescents, youth and adults in Russia.
Avoid negative and fatalist attitudes towards effectiveness of activities aimed at health protection and promotion in Russia.
Involve in activities aimed at health education / promotion in the country, city, school, family, among peers and friends, juniors under the guidance of qualified experts.
Use reliable sources of information on health promotion. Check available knowledge and skills learned from other sources.
Develop effective skills of resisting to involvement into unhealthy behaviors.
Acquire practical skills of daily health promoting activities practiced with support of qualified experts at education institutes and at the place of residence.
Address parents, teachers and health professionals in case their personal behaviors do not correspond to their recommendations on health promotion.

That all Forum participants:
Help children, adolescents and youth to understand, to voice and to satisfy their interests and needs in the area of health protection and promotion.
Inform decision-makers at relevant research centers, ministries and departments on the Forum discussions and recommendations suggested by the Forum participants.
Urge decision-makers at research centers, ministries and departments to support the draft of the Federal Program Health of Adolescents of Russia. Suggest that the Federal Government and the President of the Russian Federation include it in the Presidential Program Children of Russia.
Participate in activities aimed at provision of fair information for decision making, development, planning and evaluation of specific programs on health promotion based on analysis of needs and major risk factors, as well as opinions of children, adolescents and youth.
Develop a program, aimed at control of unfavorable environmental factors, unhealthy lifestyles or predisposing traits, related to risk for health a program of health promotion including the following interrelated components: - policy (consent between the partners on the existing problems and approaches to ensuring social and physical environments, favorable for health, facilitating adoption of healthy lifestyles and avoiding risks by means of modification of environmental, behavioral and predisposing factors),
- education (attracts attention of the people to their own health and lifestyles, and facilitates health-promoting decisions and behaviors by means of increasing awareness and motivation, changing attitudes and learning skills, necessary for changing risky behaviors or environments), and- environmental support (or supportive environment, facilitating development and adoption of healthy lifestyles, choosing health, health promoting environments).
Establish these components of the program of health promotion at the local level by means of adoption of relevant officially agreed policy, which is included into laws, regulations, orders, instructions etc., that are compulsory for all parties, participating in development of health promotion policy.
Implement this policy within specific programs, activities of services for population providing information, knowledge and skills, necessary for adoption of healthy lifestyles and changing behaviors or environments. Ensure environmental support.
Provide support for this policy at all levels by means of increasing social activity on health promotion.
Carry out these activities at the individual, group, local and other levels of society in order to ensure that individuals and society increase control over health, add life to years (improve health) and add years to life (implement measures on disease prevention).
Attain and ensure independent as well as joint participation of all interested parties in development of school based programs on health promotion on the basis of modern models, including the following interrelated components:
- education in the area of health protection and promotion;
- medical care;
- psychological counseling and social care;
- provision of adequate nutrition;
- involvement in physical exercises;
- favorable psychosocial and biophysical environments;
- health promoting programs for teachers and other staff;
- concerted efforts of schools, families and public at the community level aimed at health promotion.
Ensure continuous participation of families, health professionals, teachers, mass media, interested public organizations, as well as children, adolescents and youth in these activities.

 

III.

The Russian Public Health Association implements, in collaboration with scientific and public organizations of Russia and other countries, projects to develop the recommendations of the Forum participants.
Purpose of the projects: To contribute to safeguarding and improving the health and well-being of children, adolescents and youth in Russia through prevention and reduction of controllable adverse effects on health. Develop strategies / recommendations on health promotion/ education with a focus on prevention of smoking, drinking and STD infection.
All projects are being implemented cooperatively with the participation of the Committees of the State Duma of the Russian Federation, the Ministry of Health, other federal and local organs of power, the Russian Academy of Sciences and Russian Academy of Medical Sciences, NGOs, chapters of the Association within the territories of the Russian Federation, experts and citizens.

A. A Joint Educational Program for General Practitioner Physicians and Teachers on Issues of Health Education / Promotion Among Children, Adolescents and Youth
Tasks:
An increase in qualifications among general practitioners, physicians of the medical profession and teachers on health education / promotion among children, adolescents and youth, their assimilation of preventative methods, early diagnosis, and treatment of ill health among children, adolescents and youth.
The development of a structure and principles of activity for an educational-methodological course on advanced training of physicians and teachers in the sphere of health education / promotion among children, adolescents and youth, a lecture course, and a course of clinical training.
The creation of methodological handbooks for physicians of the general medical profession and teachers on:
- health education / promotion among children, adolescents and youth,
- conducting preventive psychotherapeutic discussions and different medicinal treatments of children, adolescents and youth.
The conducting of a 3-day seminars (18 academic hours) for practicing physicians and teachers in Moscow for regions of the European part of Russia, as well as regional seminars.

B. The Dissemination of the Experience on Health Education / Promotion Among Children, Adolescents and Youth at the Local Level on the Territories of the Russian Federation as a Basis for Long-lasting Collaboration of RPHA, Governmental and Non-governmental Organizations
Task:
Implementation of innovative community prevention and treatment strategies based on experience of the projects and proposals of Russian and foreign specialists aimed at health education / promotion among children, adolescents and youth on the territories of Russian Federation.

C. Development of Activities of the Association's Center for Policy in the Area of Health Education / Promotion Among Children, Adolescents and Youth
Tasks:
The organization of independent expert analyses of government and non-government measures for health education / promotion among children, adolescents and youth, including legislative measures in the territories of the Federation and at the local level.
The preparation of an independent report on policy in the area of health education / promotion among children, adolescents and youth, including the development of an informational base (a collection of statistical information from various departments, a reference collection, and an Association library on this problem).
The publication of an information newsletter for NGOs and the public on the problem of health education / promotion among children, adolescents and youth.

D. Forum Follow-up Conferences and Meetings, Organized With Support of RPHA Chapters on Territories of Russia With Involvement of Decision Makers Responsible for Implementation of the Forum Recommendations and All Interested Parties

E. Publication and Distribution of Health Education Materials Based on the Recent Data and Analysis Produced by the Forum.

Association is seeking funding for the implementation of Forum participants recommendations addressed to the RPHA and contained in Part III of the Document of the Forum, possibly as a Phase II of the Project.

 

Supplement.

 

Excerpts from Report on Social marketing study of adolescent health education/promotion in Russia (1).

II. Goal and Objectives

Goal:
Social marketing study of public opinion of three population groups: schoolchildren, their parents and teachers in ten cities of Russia (Moscow, Saint-Petersburg, Kaliningrad, Krasnodar, Orenburg, Novosibirsk, Kemerovo, Perm, Yaroslavl, Ekaterinburg) for analysis of their attitudes towards their own health, especially towards psychoactive substance use, how informed are they on these issues, which sources of information are being used, and of their willingness for and need of educating interventions for development of healthy lifestyles skills.

Objectives:
1. Survey of schoolchildren of 5 through 11 grades in secondary schools of the listed ten cities of Russia.
2. Survey of parents of schoolchildren, included in this study.
3. Survey of teachers of schoolchildren, included in this study.

 

III. Study design

The design of this social marketing study was determined according to its goal and objectives. The study was conducted in November 1997 January 1998. As the most appropriate approach the experts suggested to implement the social marketing study of public opinion. Such study permits to identify the most important variables of opinion among adolescents: their attitude towards the problem, current use of alcohol, drugs and smoking, awareness of the STDs, how informed they are, and which sources of information are used, as well as they willingness and readiness to make decisions related to their own behavior in terms of healthy lifestyles.
Social marketing research collected data by interviewing three target groups: 1) schoolchildren of 5 - 8 grades and schoolchildren of 9 - 11 grades; 2) their teachers at school; 3) their parents. Survey methodology and questionnaires were designed by the leading Russian experts with due consideration of relevant Russian and international experience, and discussed at the project consultative committee meeting. Sample survey was conducted in 10 cities of Russia: Ekaterinburg, Kaliningrad, Kemerovo, Krasnodar, Moscow, Novosibirsk, Orenburg, Perm, Saint Petersburg, Yaroslavl.
The study used the technique of filling in an anonymous questionnaire. For the study in each city there was selected an ordinary secondary school in an ordinary part of the city (excluding lycees, gymnasiums, colleges, special schools, pay schools, private schools, experimental education facilities). Questionnaires were filled in during classes. The questionnaires for parents were distributed to the schoolchildren with the instruction for parents to fill them in and return on the next day. Teachers were filling in the questionnaires predominantly at teachers meetings and partly on the individual basis.
The information from the filled-in questionnaires was fed into computer and processed according to specially designed programs. Analysis of filled-in questionnaires and preparation of report were performed in Moscow.
According to calculations, in order to receive statistically significant results of the study there are needed at least 80-100 respondents in each age and sex group. Therefore 1,400-1,500 schoolchildren had to be interviewed (7 age groups, and if boys and girls are considered 14 groups). In the selected school the local interviewer selected 7 classes from 5 through 11 grades. With the average number of schoolchildren in each class approximately 20, in each school 150 questionnaires had to be completed. The return of questionnaires from the parents should be at least 70%, thus at least 1,000 completed questionnaires should be received from the parents. In each school there should be completed approximately 50 questionnaires of teachers of 5 through 11 grades, total number of completed questionnaires of teachers should be 450 500. All these requirements necessary for the results of the study to be statistically significant were met in this study.
This study is topical because among the most important factors responsible for deteriorating health status of children and youth are high prevalence of self-destructive behaviors, such as psychoactive substance use, as well as risky sexual behaviors related to contracting STDs.
This study is new for Russia. Speedy development of market relations in Russia makes possible free choice of goods and services for citizens. This is also true for the systems of health care and education. That is why currently the appropriate information supplies is a priority. Development of adequate preventive activities in the system of development of strong skills of healthy lifestyles among population requires clear understanding of the current situation in this sphere, of qualitative and quantitative variables of information supplies, as well as of needs in various forms and tools of education interventions. Marketing approach is especially effective among adolescents. Health education started in early age helps to make health-promoting lifestyles decisions.

IV. Results and Discussion

The survey of the practices and approaches provided a clear and comprehensive vision of the issues of adolescent health education, of what is being done currently and the expectations of the target subgroups. This survey provided evaluative information on the actual practices and their effectiveness. Based on the data obtained and analyzed, topics for discussion/recommendations at the policy workshops were identified and finalized.
According to the goal and objectives of the study 1,491 children, attending schools in ten cities of Russia were interviewed. Information obtained was distributed during analysis into two large groups for schoolchildren of 5-8 grades - 804 respondents, and for schoolchildren of 9-11 grades - 687 respondents, according to approaches of age-specific and pedagogical psychology.
The key role in acquiring healthy lifestyles skills among children belongs to their immediate social circles: family, parents, and to the attitudes towards health and health-promoting behaviors among the latter, that may serve as an example and educating factor for children. Therefore simultaneously with the children their parents were interviewed. We were interested, first of all, in their own behaviors, for example, in their attitude to unhealthy habits (use of psychoactive substances), to some issues relating to health of their children, how informed are the parents in the issues included into the study, which sources of information they use, their needs in such information and various formats of education interventions for their children, as well as some other relevant issues. For this purpose 1,054 parents, including 851 women and 203 men were interviewed in ten cities of Russia.
The children spend much of their time at school and here the considerable part of education activities implemented by teachers takes place, as well as provision of various information and knowledge. Therefore teachers of secondary schools which the interviewed schoolchildren were attending, were included into the study. 452 teachers teaching certain school subjects participated in the study. They predominantly possess higher education, and their age was from 19 to 70 years.
The study had demonstrated importance of social marketing analysis of the issues of healthy lifestyles among schoolchildren. Simultaneous survey of three population groups adolescents, their parents and teachers can better reveal the existing trends in the attitudes of population towards the issue of healthy lifestyles, in particular, towards the psychoactive substance use, sexual education, as well as on information they possess, sources of information, their needs in various formats and sources of education interventions. It was found that schoolchildren assess their own health status as good. The assessment of health of children by their parents and teachers is less positive.
Among values of life among children health occupies one of the first ranks. This suggests that children are ready for the educating intervention. This should be taken into account during development of preventive programs.
However, though children are interested in issues of own health, the situation is different when their actual behaviors are considered. For example, analysis of the problem of leisure time, directly related to healthy lifestyles, suggests that schoolchildren spend the bulk of their leisure time watching TV and video programs.
Walking in the street with friends is currently very prevalent among schoolchildren, thus schoolchildren spend considerable part of their leisure time wandering aimlessly in the streets. This is a risk factor for unhealthy behaviors, including first use of psychoactive substances (smoking, alcohol use, drugs and toxic substances).
The schoolchildren surveyed are interested in the issues of physical activity, they perform morning physical drills, running, go in for various sports groups. In doing this they predominantly use the possibilities provided by the school. Use of various physical training, aerobics, shaping centers etc. is less prevalent because these are expensive, of scarce availability and poor accessibility.
Schoolchildren of both age groups are rather well acquainted with psychoactive substances use. Over half of them smoke. Prevalence of smoking is rising with increasing age of child.
Over half of schoolchildren surveyed do use alcohol, in senior grades two thirds of schoolchildren do this.
Schoolchildren are also acquainted with the use of drugs and toxic substances: among schoolchildren in 5 - 8 grades 3%, in 9 - 11 grades 15%.
It should be emphasized here that schoolchildren are the most well-off group of adolescents. Currently schools can select pupils, and children with unsatisfactory results of studies, poor behavior, etc. stay outside schools. Therefore, schools are attended by well adapted children, which are willing to continue studies, thus the level of psychoactive substance use found in this study should be considered as rather high.
Practically every adolescent interviewed is aware of existence of STDs (up to 86.6% of respondents), awareness increases with increasing age of child.
Schoolchildren demonstrated much interest in various aspects of healthy lifestyles. They highly assess importance of their own health, and are most interested in topics related to physical fitness, sports, physical activity. They are interested in the issues of sexual education, as well as in the issues, related to balanced diet, overweight and inadequate nutrition, in particular. Schoolchildren wish to receive positive information, advice and recommendations of experts and specialists in healthy lifestyles, in advice format. Schoolchildren are considerably less interested in information in prohibitive format, in particular, related to psychoactive substance use.
Schoolchildren are well aware that smoking, alcohol and drugs use are extremely harmful for human health, however they do not extrapolate this to their own health and behaviors. At least half of respondents smoke and use alcohol more or less intensively, and do not express much interest in any education interventions related to these issues.
Schoolchildren receive information on smoking, alcohol and drugs use, on STDs from TV broadcasts, books and periodicals, from their friends and parents.
Schoolchildren would like to receive information on health, healthy lifestyles first of all during classes at school (i.e. such information should be systematized and adapted specially for them, their age, sex, immediate social environments etc.), from parents (especially junior children), from TV broadcasts, video films, periodicals, discussions and lectures.
Schoolchildren believe that information on unhealthy behaviors should be presented among school populations starting from the age of 12 years, or from the 6-th grade.
Schoolchildren believe that health promotion activities should be implemented by teachers, physicians and parents. It should be emphasized that adolescents understand that they should be themselves interested in this.
-Schoolchildren believe that what is needed for health promotion is first of all the strong personal will. Availability of funds, facilities, relevant programs, specialists, literature, is secondary, in their opinion.
Schoolchildren expressed positive attitudes towards their families, though with increasing age this trend is somewhat weakening. Schoolchildren believe that they receive attention in the family mainly from mother, number of respondents stating that attention is received mainly from the father is twice less. Other relatives are mentioned in this context even less frequently.
Schoolchildren prefer staying with parents. They value highly interrelations in the family, and in case problems with alcohol or drug use will arise, they will seek help first of all among family members.
Comprehensive analysis of data collected according to the same questions in the three groups studied suggests that some issues are understood differently by each of these groups. This fact should be taken into account during development of preventive programs.
Health status of schoolchildren is assessed most positively by schoolchildren themselves, less positively by their teachers and the least positive assessment belongs to their parents.
All three groups believe that the most harmful for health is the use of drugs, alcohol and smoking. However these detrimental practices are represented among all groups included into this study.
All three groups studied receive information on health and healthy lifestyles from TV and other mass media, and in the future adults would prefer these sources of information. Schoolchildren want to receive relevant information from their teachers, parents, lecturers, i.e. to receive information specially adapted for children during direct contact with adults. Schoolchildren need attention and care of adults, especially of their parents.
Health promotion activities among schoolchildren should be implemented, as parents believe, first of all by parents and relatives (71.6%), by schoolchildren themselves (50.6%), by physicians (30.1%), by sports trainers (23.5%). Teachers believe that these activities should be implemented by parents and relatives (63.8%), by physicians (46.8%), by schoolchildren themselves (44.7%). Schoolchildren believe that these activities should be implemented by schoolchildren themselves (75.7%), physicians (32.6%), parents and relatives (21.5%), sports trainers (17.4%), and only 2.1% - by teachers.
Parents and teachers believe that health promotion activities among schoolchildren is important, and for that financial resources, special facilities, programs, specialists, etc. material resources are needed. Schoolchildren believe that they should implement such activities themselves. This implies that schoolchildren are ready to participate in the relevant activities, in case these will be suggested by adults.
Parents and teachers believe that preventive interventions among children aimed at psychoactive substance use and risky sexual behaviors, resulting in STDs are necessary
Adults themselves discuss these issues with children, but not on a regular basis. Some answers of adults suggest that they do not possess technique of this work, and relevant scientific substantiation. Majority of parents (2/3 of them) believe that they are well informed on the issues of healthy lifestyles, and are satisfied with their relevant skills. However prevalence of psychoactive substance use among parents revealed during the study, suggests that parents themselves are in need of health promoting and preventive interventions.
General analysis of information received from schoolchildren and parents suggests that health education in the family should be interactive, including development of relevant preventive programs by specialists, for various groups of population, schoolchildren and their parents. Many parents surveyed indicated that they practically do not possess time for such work in the family. Therefore it should be recommended to pay necessary attention to organization of work at schools, that are the most organized part of the pedagogical process, in development of preventive activities.
Comparative study of psychoactive substances use among schoolchildren in various cities of Russia could yield important additional information.

References:

1. .. Demine, Ye.A. Koshkina, I.D. Paronyan, V.N. Gurtovenko, G.A.Korchagina, K.V. Vyshinskii, N.Ya. Konstantinova, A.V. Karpets, I.A. Demina. Social marketing study of adolescent health education/promotion in Russia, conducted in November 1997 January 1998 in three population groups - schoolchildren, their parents and teachers in ten cities of Russia - Moscow, Saint-Petersburg, Kaliningrad, Krasnodar, Orenburg, Novosibirsk, Kemerovo, Perm, Yaroslavl, Ekaterinburg within a USAID-sponsored project All-Russia Public Health Policy Forum Health Education/Promotion Among Adolescents in Russia (October 1, 1997 - March 30, 1998). Collection and analysis of data for Ekaterinburg implemented within a joint project of the Russian Public Health Association and Canadian Feed the Children. Summary prepared by Dr. Andrei K. Demine, MD, PhD, MPH, President of RPHA. Russian Public Health Association, Moscow, 1998 12 p.

2. Russian Public Health Association. All-Russia Public Health Policy Forum Health Education/Promotion Among Adolescents in Russia (October 1, 1997 - March 30, 1998), a Project sponsored by USAID. Final Report on the Project Activities. Prepared by Dr. Andrei K. Demine, MD, PhD, MPH, President of RPHA. Russian Public Health Association, Moscow, 25 August 1998 16 p.

3. Russian Public Health Association. All-Russia Public Health Policy Forum Health Education/Promotion Among Adolescents in Russia (October 1, 1997 - March 30, 1998). A Project sponsored by USAID (Canadian Feed the Children provided funding for social marketing study in Ekaterinburg within a CFTC-RPHA project). I. Project Information, II. Basic Positions and Policy Recommendations in the Area of Public Health, Oriented Towards the Preservation and Promotion of Health and Welfare of Children, Adolescents and Youth in Russia A Vision of Health for Children, Adolescents and Youth in Russia, suggested by the Forum participants, and III. Information About the Future Project Work (based on project materials, as on 5 August 1998). Prepared by Dr. Andrei K. Demine, M.D., Ph.D., M.P.H., project leader, President of Russian Public Health Association and Dr. Irina A. Demina, M.D., Vice - President of Russian Public Health Association. Moscow 1998. 24 p.

 

Andrey K. Demin, Irina A. Demina, 1998
Russian Public Health Association, 1998
Publication of the Russian Public Health Association. Print 500 copies.


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